title: Chronic low back pain: non-clinical factors impacting on management by Irish doctors.
abstract: BACKGROUND
  General practitioners and consultants in the Republic of Ireland manage patients with chronic low back pain (LBP), but little is known about the non-clinical factors that impact on their management.
  
  
  OBJECTIVE
  To establish the non-clinical factors that impact on the management of chronic LBP by a cohort of general practitioners and consultants.
  
  
  METHODS
  Using a multiple case study design, semi-structured interviews were conducted with general practitioners (n = 7) and consultants (n = 7). Interviews were transcribed and analysed qualitatively.
  
  
  RESULTS
  Two main themes emerged: policy factors (the health care system, the medico-legal system), and patient factors (need for reassurance, lack of patient adherence).
  
  
  CONCLUSIONS
  These factors operate at national and local levels. Nationally, they underscore the lack of resources, and the impact of the medico-legal system. Local issues include changing practice by reassuring patients using evidence-based biopsychosocial strategies to maximise patient care and reduce healthcare costs.
authors.affiliation: School of Physiotherapy and Performance Science, Health Science Centre, University College Dublin, Dublin, Republic of Ireland. brona.fullen@ucd.ie
authors.forename: B M
authors.initials: BM
authors.lastname: Fullen
authors.forename: C
authors.initials: C
authors.lastname: Doody
authors.forename: G
authors.initials: G
authors.lastname: David Baxter
authors.forename: L E
authors.initials: LE
authors.lastname: Daly
authors.forename: D A
authors.initials: DA
authors.lastname: Hurley
mesh_terms: D000328:Adult; D016009:Chi-Square Distribution; D002908:Chronic Disease; D005260:Female; D006291:Health Policy; D006801:Humans; D007407:Interviews as Topic; D007494:Ireland / Q000453:epidemiology; D017116:Low Back Pain / Q000453:epidemiology / Q000628:therapy*; D008297:Male; D010349:Patient Compliance; D010817:Physician-Patient Relations; D010821:Physicians, Family; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D018709:Statistics, Nonparametric