General practitioners' treatment orientations towards low back pain: influence on treatment behaviour and patient outcome.

Judith M. Sieben, J.W.S. Vlaeyen, P.J.M. Portegijs, FC Warmenhoven, A.G. Sint, N. Dautzenberg, A Romeijnders, A.R. Arntz, J.A. Knottnerus

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Abstract

Background: In low back pain (LBP) treatment and research attention has shifted from a biomedical towards a biopsychosocial approach. Patients' LBP beliefs and attitudes were found to predict long-term outcome, and recently it has been suggested that the health care providers' ideas about LBP are also important predictors of treatment behaviour and Outcome. Aims: In the present study we examined whether (1) differences in General Practitioners' (GP) LBP treatment orientation are associated with differences in actual treatment behaviour and (2) whether treatment orientation is related to LBP outcome in patients. Methods: Two hundred twenty two patients consulting their GP with a new episode of LBP were recruited and completed questionnaires on (among others) LBP outcome (graded chronic pain scale) at baseline, during 12 months of follow-up and at the end of the study. Data on treatment were collected from the GPs. The GPs also completed a set of questionnaires on LBP treatment orientation. Associations between measures of treatment orientation, treatment recommendations, treatment behaviour and LBP outcome were analysed. Results: A biomedical treatment orientation was found to be associated with more concern about tissue damage and the effect of physical activity on pain and recovery in vignettes. No associations were found between treatment orientation measures, actual treatment behaviour and LBP outcome. Conclusions: Associations were not found as expected. Still these findings are relevant and may feed a clinically important debate on widely accepted assumptions about the role and influence of health care providers in changing patients' pain behaviours.
Original languageEnglish
Pages (from-to)412-418
JournalEuropean Journal of Pain
Volume13
Issue number4
DOIs
Publication statusPublished - 1 Jan 2009

Cite this

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title = "General practitioners' treatment orientations towards low back pain: influence on treatment behaviour and patient outcome.",
abstract = "Background: In low back pain (LBP) treatment and research attention has shifted from a biomedical towards a biopsychosocial approach. Patients' LBP beliefs and attitudes were found to predict long-term outcome, and recently it has been suggested that the health care providers' ideas about LBP are also important predictors of treatment behaviour and Outcome. Aims: In the present study we examined whether (1) differences in General Practitioners' (GP) LBP treatment orientation are associated with differences in actual treatment behaviour and (2) whether treatment orientation is related to LBP outcome in patients. Methods: Two hundred twenty two patients consulting their GP with a new episode of LBP were recruited and completed questionnaires on (among others) LBP outcome (graded chronic pain scale) at baseline, during 12 months of follow-up and at the end of the study. Data on treatment were collected from the GPs. The GPs also completed a set of questionnaires on LBP treatment orientation. Associations between measures of treatment orientation, treatment recommendations, treatment behaviour and LBP outcome were analysed. Results: A biomedical treatment orientation was found to be associated with more concern about tissue damage and the effect of physical activity on pain and recovery in vignettes. No associations were found between treatment orientation measures, actual treatment behaviour and LBP outcome. Conclusions: Associations were not found as expected. Still these findings are relevant and may feed a clinically important debate on widely accepted assumptions about the role and influence of health care providers in changing patients' pain behaviours.",
author = "Sieben, {Judith M.} and J.W.S. Vlaeyen and P.J.M. Portegijs and FC Warmenhoven and A.G. Sint and N. Dautzenberg and A Romeijnders and A.R. Arntz and J.A. Knottnerus",
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General practitioners' treatment orientations towards low back pain: influence on treatment behaviour and patient outcome. / Sieben, Judith M.; Vlaeyen, J.W.S.; Portegijs, P.J.M.; Warmenhoven, FC; Sint, A.G.; Dautzenberg, N.; Romeijnders, A; Arntz, A.R.; Knottnerus, J.A.

In: European Journal of Pain, Vol. 13, No. 4, 01.01.2009, p. 412-418.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - General practitioners' treatment orientations towards low back pain: influence on treatment behaviour and patient outcome.

AU - Sieben, Judith M.

AU - Vlaeyen, J.W.S.

AU - Portegijs, P.J.M.

AU - Warmenhoven, FC

AU - Sint, A.G.

AU - Dautzenberg, N.

AU - Romeijnders, A

AU - Arntz, A.R.

AU - Knottnerus, J.A.

PY - 2009/1/1

Y1 - 2009/1/1

N2 - Background: In low back pain (LBP) treatment and research attention has shifted from a biomedical towards a biopsychosocial approach. Patients' LBP beliefs and attitudes were found to predict long-term outcome, and recently it has been suggested that the health care providers' ideas about LBP are also important predictors of treatment behaviour and Outcome. Aims: In the present study we examined whether (1) differences in General Practitioners' (GP) LBP treatment orientation are associated with differences in actual treatment behaviour and (2) whether treatment orientation is related to LBP outcome in patients. Methods: Two hundred twenty two patients consulting their GP with a new episode of LBP were recruited and completed questionnaires on (among others) LBP outcome (graded chronic pain scale) at baseline, during 12 months of follow-up and at the end of the study. Data on treatment were collected from the GPs. The GPs also completed a set of questionnaires on LBP treatment orientation. Associations between measures of treatment orientation, treatment recommendations, treatment behaviour and LBP outcome were analysed. Results: A biomedical treatment orientation was found to be associated with more concern about tissue damage and the effect of physical activity on pain and recovery in vignettes. No associations were found between treatment orientation measures, actual treatment behaviour and LBP outcome. Conclusions: Associations were not found as expected. Still these findings are relevant and may feed a clinically important debate on widely accepted assumptions about the role and influence of health care providers in changing patients' pain behaviours.

AB - Background: In low back pain (LBP) treatment and research attention has shifted from a biomedical towards a biopsychosocial approach. Patients' LBP beliefs and attitudes were found to predict long-term outcome, and recently it has been suggested that the health care providers' ideas about LBP are also important predictors of treatment behaviour and Outcome. Aims: In the present study we examined whether (1) differences in General Practitioners' (GP) LBP treatment orientation are associated with differences in actual treatment behaviour and (2) whether treatment orientation is related to LBP outcome in patients. Methods: Two hundred twenty two patients consulting their GP with a new episode of LBP were recruited and completed questionnaires on (among others) LBP outcome (graded chronic pain scale) at baseline, during 12 months of follow-up and at the end of the study. Data on treatment were collected from the GPs. The GPs also completed a set of questionnaires on LBP treatment orientation. Associations between measures of treatment orientation, treatment recommendations, treatment behaviour and LBP outcome were analysed. Results: A biomedical treatment orientation was found to be associated with more concern about tissue damage and the effect of physical activity on pain and recovery in vignettes. No associations were found between treatment orientation measures, actual treatment behaviour and LBP outcome. Conclusions: Associations were not found as expected. Still these findings are relevant and may feed a clinically important debate on widely accepted assumptions about the role and influence of health care providers in changing patients' pain behaviours.

U2 - 10.1016/j.ejpain.2008.05.002

DO - 10.1016/j.ejpain.2008.05.002

M3 - Article

VL - 13

SP - 412

EP - 418

JO - European Journal of Pain

JF - European Journal of Pain

SN - 1090-3801

IS - 4

ER -