Nonclinical Factors Impact Back Pain Treatment Decisions

Patient presentation, socioeconomic status, gender influence physician treatment decisions

FRIDAY, Oct. 28 (HealthDay News) -- Nonclinical factors, including gender, socioeconomic status, and patient presentation, influence physicians' treatment recommendations for acute nonspecific low back pain, with patient presentation the most influential factor, according to a study published in the Nov. 1 issue of Spine.

Shira S. Weiner, Ph.D., from the New York University Langone Medical Center in New York City, and colleagues examined the influence of nonclinical patient factors, including gender, patient presentation, and socioeconomic status, on physician assessment and treatment of acute nonspecific low back pain. One vignette and a questionnaire asking for diagnostic and treatment recommendations, including specific tests, medications, therapeutic procedures, activity, referral to other services, and patient education, were given to 284 physicians (approximately 75 percent with less than five years of clinical experience) from primary care and emergency departments.

The investigators found seven significant associations for patient factors with treatment recommendations for acute nonspecific low back pain. These associations included one for gender, two for socioeconomic status, and four for patient presentation.

"All three assessed nonclinical factors influenced physician decisions regarding diagnostic and treatment recommendations for acute nonspecific low back pain. Patient presentation, suggestive of a patient's emotional state, was shown to be the most influential," the authors write.

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