Development of a Patient-Oriented Intervention to Support Patient-Provider Conversations about Unnecessary Lower Back Pain Imaging

Maryam Madani Larijani, Cindy Dumba, Heather Thiessen, Angie Palen, Tracey Carr, Jason R. Vanstone, Daryl R. Fourney, Collin Hartness, Robert Parker and Gary Groot
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Maryam Madani Larijani: Community Health and Epidemiology, University of Saskatchewan, Saskatoon, SK S7N 5E5, Canada
Cindy Dumba: Patient and Public Partner of Choosing Wisely Canada, Regina, SK S4S 4V4, Canada
Heather Thiessen: Saskatchewan Patient & Family Leadership Council, Saskatoon, SK S7K 7P8, Canada
Angie Palen: Choosing Wisely Saskatchewan, Saskatoon, SK S7K 1P3, Canada
Tracey Carr: Community Health and Epidemiology, University of Saskatchewan, Saskatoon, SK S7N 5E5, Canada
Jason R. Vanstone: Saskatchewan Health Authority, Regina, SK S4P 0W5, Canada
Daryl R. Fourney: Division of Neurosurgery, University of Saskatchewan, Saskatoon, SK S7N 0W8, Canada
Collin Hartness: Saskatchewan Health Authority, Regina, SK S4P 0W5, Canada
Robert Parker: Saskatchewan Health Authority, Regina, SK S4P 0W5, Canada
Gary Groot: Community Health and Epidemiology, University of Saskatchewan, Saskatoon, SK S7N 5E5, Canada

IJERPH, 2021, vol. 18, issue 5, 1-13

Abstract: Background: despite the efforts of multiple stakeholders to promote appropriate care throughout the healthcare system, studies show that two out of three lower back pain (LBP) patients expect to receive imaging. We used the Choosing Wisely Canada patient-oriented framework, prioritizing patient engagement, to develop an intervention that addresses lower back pain imaging overuse. Methods: to develop this intervention, we collaborated with a multidisciplinary advisory team, including two patient partners with lower back pain, researchers, clinicians, healthcare administrators, and the Choosing Wisely Canada lead for Saskatchewan. For this qualitative study, data were collected through two advisory team meetings, two individual interviews with lower back pain patient partners, and three focus groups with lower back pain patient participants. A lower back pain prescription pad was developed as an outcome of these consultations. Results: participants reported a lack of interactive and informative communication was a significant barrier to receiving appropriate care. The most cited content information for inclusion in this intervention was treatments known to work, including physical activity, useful equipment, and reliable sources of educational material. Participants also suggested it was important that benefits and risks of imaging were explained on the pad. Three key themes derived from the data were also used to guide development of the intervention: (a) the role of imaging in LBP diagnosis; (b) the impact of the patient-physician relationship on LBP diagnosis and treatment; and (c) the lack of patient awareness of Choosing Wisely Canada and their recommendations. Conclusions: the lower back pain patient-developed prescription pad may help patients and clinicians engage in informed conversations and shared decision making that could support reduce unnecessary lower back pain imaging.

Keywords: lower back pain; patient engagement; patient education; physician-patient relation; Choosing Wisely Canada; diagnostic imaging; primary healthcare (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
References: View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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