Background & Aims

Low back pain is a global issue with significant negative personal and economic consequences [2,4,5]. Choosing Wisely initiatives emphasize the importance of patient involvement in guideline and material development with the aim of promoting informed healthcare decisions and minimize low-value care [1,6,7]. Patient-clinician-focused or multicomponent approaches are crucial for integrating guidelines aimed at promoting high-value care by discouraging unnecessary tests and treatments in the context of low back pain [1,6,7]. The objective of this project is to develop an information resource in the form of a leaflet, that could be distributed in a clinical setting, websites or on social media targeting people with low back pain. The purpose of the leaflet is to reduce the use of MRI or X-ray in patients with low back pain, when there is no clinical suspicion of serious illness.

Methods

The development process was collaboratively driven by a cross-sectional steering group. This multi-method study was conducted in four stages: systematic literature search, input from practice consultants, program theory development, and think-aloud interviews with people experiencing low back pain. Each stage was followed by a consensus meeting in which the steering group refined the leaflet based on emerging knowledge.

Results

The systematic search yielded 34 papers highlighting patients’ need for understandable information about diagnosis, prognosis, treatment options, and self-management strategies. Practice consultants emphasized concise, relatable content targeted at those at risk of poor prognosis. The program theory identified potential mechanisms and design targets for content creation, development, and implementation of the leaflet, such as addressing patient concerns, reducing diagnostic uncertainty, offering insights into management options, and validating the experience. Think-aloud interviews with 18 people living with low back pain informed the modulation of the leaflet design, to inform language clarification and content comprehension.

Conclusions

In this study, we developed a new Choosing Wisely leaflet, created with end-users in mind, specifically focusing on reducing unnecessary imaging for managing low back pain. By involving end-users and practice consultants in the development process, the leaflet ensured comprehensive and relevant content for people with the lived experience of low back pain and clinical practice.

References

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Presenting Author

Chris Djurtoft

Poster Authors

Chris Djurtoft

MSc

Research Unit for General Practice at Aalborg University

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Edel O'Hagan

The University of Sydney

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Monika Deleuran Laursen

North Denmark Region

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Lars Lejbølle

North Denmark Region

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Mia Bisgaard Jensen

North Denmark Region

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Simon Kristoffer Johansen

Research Unit for General Practice at Aalborg University

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Kristian Damgaard Lyng

Aalborg University

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Morten Hoegh

Aalborg University

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Negar Pourbordbari

Research Unit for General Practice at Aalborg University

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Jesper Bie Larsen

Aalborg University

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Malene Kjær Bruun

Research Unit for General Practice at Aalborg University

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Bettina Eiger

Rehabilitation Centre, Køge Municipality, Køge, Denmark

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Michael Skovdal Rathleff

Research Unit for General Practice at Aalborg University

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Topics

  • Specific Pain Conditions/Pain in Specific Populations: Low Back Pain