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Cited by 196Musculoskeletal pain and rehabilitationHealthcare cost, quality, practicesOpioid Use Disorder Treatment

The DOI matches its Crossref record; 53 of the 55 references it cites were found in a registry or an index.

What is usual care for low back pain? A systematic review of health care provided to patients with low back pain in family practice and emergency departments

Kamper, Steven J., Logan, Gabrielle, Copsey, Bethan, Thompson, Jacqueline, Machado, Gustavo C., Abdel-Shaheed, Christina, Williams, Christopher M., Maher, Christopher G., Hall, Amanda M.·2020·Pain
DOI 10.1097/j.pain.0000000000001751
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Abstract

International clinical practice guidelines for low back pain (LBP) contain consistent recommendations including universal provision of information and advice to remain active, discouraging routine referral for imaging, and limited prescription of opioids. This systematic review describes usual care provided by first-contact physicians to patients with LBP. Studies that reported the assessments and care provided to people with LBP in family practice and emergency departments (EDs) from January 2000 to May 2019 were identified by searches of PubMed, EMBASE, and CINAHL. Study quality was assessed with reference to representativeness of samples, potential misclassification of patients, potential misclassification of outcomes, inconsistent data and precision of the estimate, and the findings of high-quality studies were prioritized in the data synthesis. We included 26 studies that reported data from almost 195,000 patients: 18 from family practice, and 8 from EDs. Less than 20% of patients with LBP received evidence-based information and advice from their family practitioner. Around 1 in 4 patients with LBP received referral for imaging in family practice and 1 in 3 in EDs. Up to 30% of patients with LBP were prescribed opioids in family practice and up to 60% in EDs. Large numbers of patients who saw a physician for LBP received care that is inconsistent with evidence-based clinical practice guidelines. Usual care included overuse of imaging and opioid prescription and underuse of advice and information. Suboptimal care may contribute to the massive burden of the condition worldwide.

Overview

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Registry

Crossref · 10.1097/j.pain.0000000000001751

Cites

53 of 53 references verified0 citation errors · 0 not checkable

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Citations

Cites

Show all 55 references

Research works printed but not linked: 3

  1. Chen, 2013, Adoption of new electronic medical records may inhibit documentation of physician quality reporting system, Arthritis Rheum, 65, S817
  2. Downie, 2019, Accepted for 18/12/18. How common is imaging for low back pain? Systematic review and meta-analysis, Br J Sports Med
  3. Muntion-Alfaro, 2006, Back pain: do we follow the recommendations in the guidelines?, Atencion Primaria, 37, 215

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Metadata

Authors
Kamper, S. J., Logan, G., Copsey, B., Thompson, J., Machado, G. C., Abdel-Shaheed, C., Williams, C. M., Maher, C. G., & Hall, A. M.
Affiliations
  • The University of Sydney (AU)
  • Memorial University of Newfoundland (CA)
  • University of Oxford (GB)
  • Institute for Musculoskeletal Health, Faculty of Medicine and Health, University of Sydney, Australia
  • Hunter New England Local Health District (AU)
Corresponding author
Kamper, Steven J.
ORCID
Venue
Pain
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2019-11-14
Volume
161
Issue
4
Pages
694-702
ISSN
  • 0304-3959 (ISSN-L)
  • 1872-6623
DOI
10.1097/j.pain.0000000000001751
OpenAlex
W2983434735
Cited by
196
References
55
Citations by year
2026: 20 · 2025: 27 · 2024: 26 · 2023: 39 · 2022: 47 · 2021: 26 · 2020: 10 · 2019: 1
FWCI
2.69
Type
journal article
Language
en
Open access
closed
Locations
  • Pain (publishedVersion)
  • PubMed (publishedVersion)
  • University of Birmingham Research Portal (University of Birmingham) (submittedVersion)
  • NOVA (University of Newcastle Australia) (submittedVersion)
Topics
  • Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
  • Health Sciences › Health Professions › General Health Professions › Healthcare cost, quality, practices
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
Keywords
low back pain, usual care, general practice, emergency department, guideline adherence, imaging referral, opioid prescribing, first contact care, overuse of imaging
MeSH terms
Analgesics, Opioid, Delivery of Health Care, Emergency Service, Hospital, Family Practice, Humans, Low Back Pain

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