Patient and general practitioner views of tools to delay diagnostic imaging for low back pain: a qualitative study
Objective Delayed prescribing is a promising strategy to manage patient requests for unnecessary tests and treatments. The purpose of this study was to explore general practitioner (GP) and patient views of three communication tools (Overdiagnosis Leaflet, Dialogue Sheet and ‘Wait-and-see’ Note) to...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2020-11-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/10/11/e039936.full |
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| author | Adrian C Traeger Denise A O’Connor Kirsten McCaffery Loai Albarqouni Sweekriti Sharma Elise Tcharkhedian Juliet Checketts Christiane Klinner Parima Vyas |
| author_facet | Adrian C Traeger Denise A O’Connor Kirsten McCaffery Loai Albarqouni Sweekriti Sharma Elise Tcharkhedian Juliet Checketts Christiane Klinner Parima Vyas |
| author_sort | Adrian C Traeger |
| collection | DOAJ |
| description | Objective Delayed prescribing is a promising strategy to manage patient requests for unnecessary tests and treatments. The purpose of this study was to explore general practitioner (GP) and patient views of three communication tools (Overdiagnosis Leaflet, Dialogue Sheet and ‘Wait-and-see’ Note) to support delayed prescribing of diagnostic imaging.Design Qualitative study.Setting Primary and emergency care in Sydney, Australia.Participants 16 GPs and 14 patients with recent episode of low back pain.Outcome Views on the tools to delay diagnostic imaging for low back pain. Data were collected using a combination of focus groups and individual interviews.Analysis Two researchers independently performed a thematic analysis, and the author team reviewed and refined the analysis.Results GP participants responded positively to the Overdiagnosis Leaflet. The Dialogue Sheet and ‘Wait-and-see’ Note raised several concerns about patient pushback, adding to time pressure and being overwhelmed with hard-to-find paper resources. GPs preferred to communicate verbally the reasons to delay an imaging test. For patients, the reactions to the tools were more positive. Patients valued written information and a signed agreement to delay the test. However, patients expressed that a strong desire for diagnostic imaging would likely over-ride any effect of written advice to delay the test. The term ‘false alarm’ to describe overdiagnosis was poorly understood by patients.Conclusions GPs and patients agreed that a leaflet about overdiagnosis could support a delayed prescribing approach to imaging for low back pain. The Dialogue Sheet and ‘Wait-and-see’ Note were acceptable to patients but not to GPs. |
| format | Article |
| id | doaj-art-eab72779db244d67ab940eab9f2007ab |
| institution | OA Journals |
| issn | 2044-6055 |
| language | English |
| publishDate | 2020-11-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-eab72779db244d67ab940eab9f2007ab2025-08-20T02:24:04ZengBMJ Publishing GroupBMJ Open2044-60552020-11-01101110.1136/bmjopen-2020-039936Patient and general practitioner views of tools to delay diagnostic imaging for low back pain: a qualitative studyAdrian C Traeger0Denise A O’Connor1Kirsten McCaffery2Loai Albarqouni3Sweekriti Sharma4Elise Tcharkhedian5Juliet Checketts6Christiane Klinner7Parima Vyas81 Institute for Musculoskeletal Health, School of Public Health, Faculty of Medicine and Health, The University of Sydney and Sydney Local Health District, Sydney, New South Wales, AustraliaMonash Department of Clinical Epidemiology, Cabrini Institute, Monash University, Clayton, Victoria, AustraliaSydney Health Literacy Lab, Sydney School of Public Health, The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, AustraliaInstitute for Evidence-Based Healthcare, Bond University, Gold Coast, Queensland, AustraliaInstitute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, New South Wales, Australia5 Liverpool Hospital, Liverpool, New South Wales, AustraliaAustralian Government Department of Health, Canberra, Australian Capital Territory, AustraliaCentral Clinical School, The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, AustraliaAustralian Government Department of Health, Canberra, Australian Capital Territory, AustraliaObjective Delayed prescribing is a promising strategy to manage patient requests for unnecessary tests and treatments. The purpose of this study was to explore general practitioner (GP) and patient views of three communication tools (Overdiagnosis Leaflet, Dialogue Sheet and ‘Wait-and-see’ Note) to support delayed prescribing of diagnostic imaging.Design Qualitative study.Setting Primary and emergency care in Sydney, Australia.Participants 16 GPs and 14 patients with recent episode of low back pain.Outcome Views on the tools to delay diagnostic imaging for low back pain. Data were collected using a combination of focus groups and individual interviews.Analysis Two researchers independently performed a thematic analysis, and the author team reviewed and refined the analysis.Results GP participants responded positively to the Overdiagnosis Leaflet. The Dialogue Sheet and ‘Wait-and-see’ Note raised several concerns about patient pushback, adding to time pressure and being overwhelmed with hard-to-find paper resources. GPs preferred to communicate verbally the reasons to delay an imaging test. For patients, the reactions to the tools were more positive. Patients valued written information and a signed agreement to delay the test. However, patients expressed that a strong desire for diagnostic imaging would likely over-ride any effect of written advice to delay the test. The term ‘false alarm’ to describe overdiagnosis was poorly understood by patients.Conclusions GPs and patients agreed that a leaflet about overdiagnosis could support a delayed prescribing approach to imaging for low back pain. The Dialogue Sheet and ‘Wait-and-see’ Note were acceptable to patients but not to GPs.https://bmjopen.bmj.com/content/10/11/e039936.full |
| spellingShingle | Adrian C Traeger Denise A O’Connor Kirsten McCaffery Loai Albarqouni Sweekriti Sharma Elise Tcharkhedian Juliet Checketts Christiane Klinner Parima Vyas Patient and general practitioner views of tools to delay diagnostic imaging for low back pain: a qualitative study BMJ Open |
| title | Patient and general practitioner views of tools to delay diagnostic imaging for low back pain: a qualitative study |
| title_full | Patient and general practitioner views of tools to delay diagnostic imaging for low back pain: a qualitative study |
| title_fullStr | Patient and general practitioner views of tools to delay diagnostic imaging for low back pain: a qualitative study |
| title_full_unstemmed | Patient and general practitioner views of tools to delay diagnostic imaging for low back pain: a qualitative study |
| title_short | Patient and general practitioner views of tools to delay diagnostic imaging for low back pain: a qualitative study |
| title_sort | patient and general practitioner views of tools to delay diagnostic imaging for low back pain a qualitative study |
| url | https://bmjopen.bmj.com/content/10/11/e039936.full |
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