Understanding patient beliefs regarding the use of imaging in the management of low back pain.
BACKGROUND
Imaging for low back pain (LBP) remains common despite guidelines recommending against routine imaging. Patient beliefs about imaging may contribute to the problem. This study aimed to quantitatively investigate patient beliefs regarding the need for imaging in managing LBP and to investigate whether personal characteristics, pain characteristics or back pain beliefs are associated with imaging beliefs.


METHODS
A survey was performed of consecutive patients presenting to general medical practitioners in Sydney, Australia. Nine medical clinics were selected across varied socioeconomic regions. Survey questions assessed beliefs about the importance of imaging for LBP, collected demographic information, LBP history and general beliefs about back pain. Descriptive statistics and multivariate logistic regression were used to analyse findings.


RESULTS
Three hundred completed surveys were collected with a 79.6% response rate. The mean age was 44 years and 60.7% of respondents were women. Exactly, 54.3% (95% CI: 48.7-58.9%) believed that imaging was necessary for the best medical care for LBP. Exactly, 48.0% (95% CI: 42.4-53.6%) believed that everyone with LBP should obtain imaging. Increased age, lower education level, non-European or non-Anglo-saxon cultural background, history of previous imaging and Back Beliefs Questionnaire scores were associated with beliefs that imaging was necessary.


CONCLUSIONS
Approximately, half of all patients presenting to a medical doctor consider low back imaging to be necessary. This may have important implications for overutilization of low back imaging investigations. Knowledge of the factors associated with the patient's belief that imaging is necessary may be helpful in designing appropriate interventions to reduce unnecessary imaging for LBP.
Department of Health Professions, Macquarie University, Australia.
H J
HJ
Jenkins
Department of Health Professions, Macquarie University, Australia.
M J
MJ
Hancock
The George Institute for Global Health, Sydney Medical School, The University of Sydney, Australia.
C G
CG
Maher
School of Rehabilitation Therapy, Queens University, Canada.
S D
SD
French
Australian School of Advanced Medicine, Macquarie University, Australia.
J S
JS
Magnussen
D000328:Adult; D001315:Australia; D003469:Culture; D003952:Diagnostic Imaging; D005260:Female; D058006:General Practice; D006301:Health Services Needs and Demand; D006801:Humans; D016015:Logistic Models; D017116:Low Back Pain / Q000000981:diagnostic imaging* / Q000523:psychology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D011795:Surveys and Questionnaires