Back pain management in primary care: patients’ and doctors’ expectations

Georgy, Ehab E BSc MSc EMMAPA MCSP
Carr, Eloise CJ BSc (Hons) RN PGCEA RNT MSc PhD
Breen, Alan C DC PhD

Doctoral Student
Associate Dean Postgraduate Students
School of Health and Social Care, Bournemouth University, UK
Professor of Musculoskeletal Health Care, Anglo-European College of Chiropractic, UK, Director of the Institute for Musculoskeletal Research and Clinical Implementation, UK, Member of the UK General Chiropractic Council

FUNDING

The study was funded by the School of Health and Social Care at Bournemouth University.

PEER REVIEW

Not commissioned; externally peer reviewed.

CONFLICTS OF INTEREST

None.

ADDRESS FOR CORRESPONDENCE

Ehab Georgy, Bournemouth University, School of Health and Social Care, Royal London House, Second Floor, Christchurch Road, Bournemouth, Dorset, BH1 3LT, UK. Tel: +44 (0)1202 537141; fax: +44 (0)1202 962194; email: [email protected]

Received 6 September 2009

Accepted 1 November 2009

Quality in Primary Care 17(6):p 405-413, 2009.

Background

Expectations may be a key element for improving quality of health care, yet several barriers interfere with understanding and optimising expectations in back pain primary care.

Objective

To review the literature related to expectations, back pain patients’ and doctors’ expectations and sources of unmatched expectations.

Methods

Review of qualitative and quantitative studies investigating back pain management in primary care settings, and eliciting patients’ and/or doctors’ pre-visit or post-visit expectations.

Results

Reviewing the literature reveals that expectations are defined and conceptualised in various ways, with several terms used interchangeably, which suggests a lack of clear definition and conceptual framework. Patients have a wide range of specific expectations for care, which can be measured, and may play a vital role in their satisfaction: doctors also seem to have their own expectations. However, studies of such expectations are scarce and there is a lack of valid measurement tools to capture such aspects.

Discussion

Shortcomings in literature included the use of different meanings and definitions for expectations, which interfered with understanding the results of previous research. Previous studies focused on patients’ general rather than condition-specific expectations; no study explored doctors’ expectations or the congruency between patients’ and doctors’ back pain-specific expectations.

Conclusions

There is a need for standardisation of definition in expectations research and a valid measurement tool that is condition specific. Understanding patients’ and doctors’ expectations may be a key factor for improving quality of care, in terms of both process and outcome.