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Health care provider back pain beliefs unaffected by a media campaign SJPHC 2008; 26 (1): 50-56

Health care provider back pain beliefs unaffected by a media campaign SJPHC 2008; 26 (1): 50-56. Erik L. Werner; MD PhD Family doctor, Arendal, Norway Research Unit for General Practice / Unifob Health, Bergen, Norway. Background. LBP: 5 – 10 % of all contacts in family practice

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Health care provider back pain beliefs unaffected by a media campaign SJPHC 2008; 26 (1): 50-56

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  1. Health care provider back pain beliefs unaffected by a media campaignSJPHC 2008; 26 (1): 50-56 Erik L. Werner; MD PhD Family doctor, Arendal, Norway Research Unit for General Practice / Unifob Health, Bergen, Norway

  2. Background • LBP: 5 – 10 % of all contacts in family practice • Societal burden: NOK 15 bill. / year • Individual burden: 15% of all sick listing and disability pension

  3. Background • Australian media campaign 1997 – 99: 15% reduction of LBP claims • ”Aktiv Rygg” – (”Active Back”): a media campaign in two Norwegian counties 2002 - 2005

  4. The media campaign Vestfold and Aust-Agder counties (325 000 inh) local papers local TV and radio local cinemas web site (www.aktivrygg.no) pamphlets posters

  5. Additional intervention Health care providers: - family doctors - physiotherapists - chiropractors Peer support intervention at work places

  6. Health care provider beliefs….. • ….. are important because they transmit beliefs to their patients – • and these beliefs are determinants for the course of the back pain episode!

  7. The ”Active Back Study”: the health care providers Material • 1100 providers • 2 intervention counties: Vestfold and Aust-Agder • Telemark as control county

  8. The ”Active Back Study”: the health care providers The intervention • The media campaign • Additional written info about the campaign • Specific courses and meetings • Posters, hand-outs

  9. The ”Active Back Study”: the health care providers The study • Questionnaires before – during - and after the campaign • Knowledge, attitudes and practices

  10. The ”Active Back Study”: the health care providers Results • 1105 providers in 2002 875 in 2005 • 243 providers answering both in 2002 and 2005 included in study - 85 ( 31 ) doctors - 83 ( 28 ) physiotherapists - 11 ( 5 ) chiropractors

  11. Providers reporting ”great interest of LBP” (n = 1105; 2002)

  12. % of LBP patients of all patients in practice

  13. Campaign exposure

  14. Statements of beliefs – level of agreement • Back pain recovers best by itself (true) • Radiograph and newer imaging tests are useful to identify the cause of the pain (false) • In most cases, back pain recovers by itself in a couple of weeks, no matter what we do (true) • Most often it will be possible to find and exact cause of the pain (false) • One recovers faster from back pain if one continues at work or returns as soon as possible (true) • Any treatment at a doctor, physiotherapist or chiropractor is symptomatic pain relieving (true) • Disc herniation should most often have surgery (false)

  15. Sum score – level of agreement with messages of the campaign in percent

  16. Conclusion • No differences in LBP beliefs among health care providers following the campaign • A general tendency of improvement in beliefs • Doctors more in line with guidelines than other health care providers • Differences between the provider groups increased during the campaign

  17. Back pain recovers best by itself (agree / totally agree)

  18. In most cases, back pain recovers by itself in a couple of weeks, no matter what we do(agree /totally agree)

  19. Any treatment at a doctor, physiotherapist or chiropractor is symptomatic pain relieving(agree / totally agree)

  20. Why is this important? • People get frustrated by different messages from different providers • Patients share beliefs of their providers • Longstanding (chronic) back pain is a matter of beliefs and attitudes more than a pathoanatomical disorder

  21. Thanks to…. Co-writers: • Douglas Gross • Stein Atle Lie • Camilla Ihlebæk ”Aktiv Rygg” staff: • Even Lærum • Aage Indahl • Erik Lindh Supervisors • Holger Ursin • Jan Sture Skouen

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