Australian General Practitioners' Use of Diagnostic Lumbar Spine Imaging for Patients With Acute Low Back Pain: A Qualitative Study.

Author(s)
Rozbroj, Tomas
Reed, Benjamin
A O'Connor, Denise
Gelber, Nicholas
Bourne, Allison
G Maher, Chris
Buchbinder, Rachelle
Publication Date
2025-06-01
Abstract
General practitioners (GPs) use of imaging for acute low back pain (LBP) is above guideline recommendations, and the reasons for this remain under-researched. We examined the perspectives, expectations and information needs of Australian GPs requesting lumbar spine diagnostic imaging for patients presenting with acute LBP.We completed semi-structured interviews with 12 GPs practising in Victoria, Australia. Transcripts were thematically analysed, and themes compared according to whether or not GPs reported they regularly requested imaging for LBP.We identified four themes. (1) Besides responding to 'red flags', GPs' experiences of uncovering unexpected but serious findings on imaging for LBP as well as perceived external pressures motivated their defensive imaging practices. (2) While most were reluctant to request imaging for LBP, once requested, GPs escalated through imaging modalities and focused on the diagnostic benefit of their findings. (3) GPs supported the inclusion of epidemiological data on imaging reports, but (4) largely opposed imaging reports being written in plain language, believing reports to be clinician-to-clinician communications that patients would misunderstand. All GPs were aware of the limited utility of imaging for diagnosing LBP, and themes were similar between GPs who regularly requested imaging and those who did not. Factors other than knowledge of imaging efficacy for LBP seemed to play an important role in imaging requests.Our study identified key drivers of imaging use for LBP in primary care. The findings underscore that interventions targeting GPs addressing the overuse of imaging for LBP should transcend knowledge deficit models.
Affiliation
School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
Royal Darwin Hospital, Tiwi, Australia.
School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
Cabrini Research, Malvern, Australia.
School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
School of Public Health, University of Sydney, Sydney, Australia.
School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
Citation
Musculoskeletal Care . 2025 Jun;23(2):e70099. doi: 10.1002/msc.70099.
ISSN
1557-0681
OrcId
0000-0002-3084-746X
0000-0003-3678-089X
0000-0002-6836-122X
0000-0002-6454-8214
0000-0002-1628-7857
0000-0002-0597-0933
Pubmed ID
https://pubmed.ncbi.nlm.nih.gov/40215089/?otool=iaurydwlib
Link
Subject
Australia
diagnostic imaging
general practice
low back pain
overdiagnosis
radiolog* report*
MESH subject
Low Back Pain
Humans
General Practitioners
Male
Qualitative Research
Female
Practice Patterns, Physicians'
Lumbar Vertebrae
Middle Aged
Adult
Victoria
Attitude of Health Personnel
Title
Australian General Practitioners' Use of Diagnostic Lumbar Spine Imaging for Patients With Acute Low Back Pain: A Qualitative Study.
Type of document
Journal Article
Entity Type
Publication

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