Clinical judgment of GPs regarding risk of long term disability in low back pain

Abstract

Chronic low back pain (CLBP) is a major healthcare burden and often results in workplace absenteeism. Thus, it is a priority for GPs to manage CLBP appropriately to get individuals back to work as early as possible. Interventions informed by the Flags approach (Kendal et al., 1999), which integrates cognitive and behavioural approaches via the identification of biopsychosocial barriers to recovery, have been observed to lead to successfully reduced pain-related work absences and increased return to work for individuals with sub-acute and CLBP. However, research indicates that physicians’ adherence to biopsychosocial guidelines is low. Although GP trainees and medical students may be open to considering biopsychosocial perspectives, their treatment strategies may overlook these features depending on the nature of their education. The current study examined the effects of a Flags-based e-learning intervention on the clinical judgments of medical students and GP trainees regarding risk of future disability of CLBP patients. Using 40 CLBP cases, differences in clinical judgment were examined pre- and post-intervention, in comparison with a no-intervention control group. Results are discussed in light of existing theory and research.