General practitioners’ treatment orientations towards low back pain: Influence on treatment behaviour and patient outcome
Corresponding Author
Judith M. Sieben
Department of Anatomy and Embryology, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
Department of Anatomy and Embryology, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands. Tel.: +31 433881056; fax: +31 433884134. [email protected]Search for more papers by this authorJohan W.S. Vlaeyen
Department of Clinical Psychological Science, Maastricht University, Maastricht, The Netherlands
Experimental Psychopathology Research Institute (EPP), Maastricht University, Maastricht, The Netherlands
Pain Management and Research Center, University Hospital Maastricht, Maastricht, The Netherlands
Search for more papers by this authorPiet J.M. Portegijs
Department of General Practice, Maastricht University, Maastricht, The Netherlands
Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
Search for more papers by this authorFranca C. Warmenhoven
Medical Student, Maastricht University, Maastricht, The Netherlands
Search for more papers by this authorAgeeth G. Sint
Medical Student, Maastricht University, Maastricht, The Netherlands
Search for more papers by this authorNadine Dautzenberg
Medical Student, Maastricht University, Maastricht, The Netherlands
Search for more papers by this authorArnold Romeijnders
Department of Guideline Development and Science, Dutch College of General Practitioners, Utrecht, The Netherlands
Search for more papers by this authorArnoud Arntz
Department of Clinical Psychological Science, Maastricht University, Maastricht, The Netherlands
Experimental Psychopathology Research Institute (EPP), Maastricht University, Maastricht, The Netherlands
Search for more papers by this authorJ. André Knottnerus
Department of General Practice, Maastricht University, Maastricht, The Netherlands
Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
Search for more papers by this authorCorresponding Author
Judith M. Sieben
Department of Anatomy and Embryology, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
Department of Anatomy and Embryology, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands. Tel.: +31 433881056; fax: +31 433884134. [email protected]Search for more papers by this authorJohan W.S. Vlaeyen
Department of Clinical Psychological Science, Maastricht University, Maastricht, The Netherlands
Experimental Psychopathology Research Institute (EPP), Maastricht University, Maastricht, The Netherlands
Pain Management and Research Center, University Hospital Maastricht, Maastricht, The Netherlands
Search for more papers by this authorPiet J.M. Portegijs
Department of General Practice, Maastricht University, Maastricht, The Netherlands
Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
Search for more papers by this authorFranca C. Warmenhoven
Medical Student, Maastricht University, Maastricht, The Netherlands
Search for more papers by this authorAgeeth G. Sint
Medical Student, Maastricht University, Maastricht, The Netherlands
Search for more papers by this authorNadine Dautzenberg
Medical Student, Maastricht University, Maastricht, The Netherlands
Search for more papers by this authorArnold Romeijnders
Department of Guideline Development and Science, Dutch College of General Practitioners, Utrecht, The Netherlands
Search for more papers by this authorArnoud Arntz
Department of Clinical Psychological Science, Maastricht University, Maastricht, The Netherlands
Experimental Psychopathology Research Institute (EPP), Maastricht University, Maastricht, The Netherlands
Search for more papers by this authorJ. André Knottnerus
Department of General Practice, Maastricht University, Maastricht, The Netherlands
Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
Search for more papers by this authorABSTRACT
Background: In low back pain (LBP) treatment and research attention has shifted from a biomedical towards a biopsychosocial approach. Patients’ LBP beliefs and attitudes were found to predict long-term outcome, and recently it has been suggested that the health care providers’ ideas about LBP are also important predictors of treatment behaviour and outcome.
Aims: In the present study we examined whether (1) differences in General Practitioners’ (GP) LBP treatment orientation are associated with differences in actual treatment behaviour and (2) whether treatment orientation is related to LBP outcome in patients.
Methods: Two hundred twenty two patients consulting their GP with a new episode of LBP were recruited and completed questionnaires on (among others) LBP outcome (graded chronic pain scale) at baseline, during 12 months of follow-up and at the end of the study. Data on treatment were collected from the GPs. The GPs also completed a set of questionnaires on LBP treatment orientation. Associations between measures of treatment orientation, treatment recommendations, treatment behaviour and LBP outcome were analysed.
Results: A biomedical treatment orientation was found to be associated with more concern about tissue damage and the effect of physical activity on pain and recovery in vignettes. No associations were found between treatment orientation measures, actual treatment behaviour and LBP outcome.
Conclusions: Associations were not found as expected. Still these findings are relevant and may feed a clinically important debate on widely accepted assumptions about the role and influence of health care providers in changing patients’ pain behaviours.
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