Aims: Imaging is overused in the management of low back pain (LBP) and previous interventions to reduce imaging are largely ineffective. Behaviour-change theory was used to develop an intervention to reduce imaging for LBP by general practitioners (GPs). The intervention includes a booklet to be used by GPs to screen, reassure, and educate patients with LBP. The aim of this study was to determine GP perspectives on the use of the developed booklet in clinical practice, prior to future effectiveness testing.
Methods: GPs from Sydney, Australia were recruited by convenience sampling. GPs were provided with the developed booklet and asked to use it with LBP patients over a minimum five month period. Audio-recorded semi-structured interviews with GPs were conducted to assess GP perceptions on: 1) their ability to use the booklet in clinical practice; and 2) how using the booklet impacted their ability to manage LBP without non-indicated imaging. Interviews were transcribed and then analysed using the Theoretical Domains Framework.
Results: Fourteen GPs were recruited and data saturation of responses was achieved. All GPs thought the booklet was appropriate for use in clinical practice. Some GPs used the booklet during the consult, whereas others handed it to the patient to read after the consult. GPs were more likely to use the booklet with patients requesting imaging. Accessibility of the booklet was an important barrier to use, and a digital version was more likely to be used. Using the booklet was perceived to improve patient management by reinforcing GP advice, facilitating communication, and providing patient education.
Conclusions: The developed booklet was perceived as a useful resource by GPs and likely to improve patient management and decrease non-indicated imaging for LBP as designed. Identified barriers will be addressed prior to future effectiveness testing to improve GP uptake and use. A successful intervention to reduce imaging for LBP would decrease healthcare costs and patient risk.