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Volume 18
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10.3390/ijerph18052786
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Article

Development of a Patient-Oriented Intervention to Support Patient-Provider Conversations about Unnecessary Lower Back Pain Imaging

by
Maryam Madani Larijani
1,
Cindy Dumba
2,
Heather Thiessen
3,
Angie Palen
4,
Tracey Carr
1,
Jason R. Vanstone
5,
Daryl R. Fourney
6,
Collin Hartness
5,
Robert Parker
5 and
Gary Groot
1,*
1
Community Health and Epidemiology, University of Saskatchewan, Saskatoon, SK S7N 5E5, Canada
2
Patient and Public Partner of Choosing Wisely Canada, Regina, SK S4S 4V4, Canada
3
Saskatchewan Patient & Family Leadership Council, Saskatoon, SK S7K 7P8, Canada
4
Choosing Wisely Saskatchewan, Saskatoon, SK S7K 1P3, Canada
5
Saskatchewan Health Authority, Regina, SK S4P 0W5, Canada
6
Division of Neurosurgery, University of Saskatchewan, Saskatoon, SK S7N 0W8, Canada
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2021, 18(5), 2786; https://doi.org/10.3390/ijerph18052786
Submission received: 10 February 2021 / Revised: 26 February 2021 / Accepted: 5 March 2021 / Published: 9 March 2021
(This article belongs to the Special Issue Empowering Patients and Supporting Health Care Providers—New Avenues for High Quality Care and Safety)
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Abstract

Background: despite the efforts of multiple stakeholders to promote appropriate care throughout the healthcare system, studies show that two out of three lower back pain (LBP) patients expect to receive imaging. We used the Choosing Wisely Canada patient-oriented framework, prioritizing patient engagement, to develop an intervention that addresses lower back pain imaging overuse. Methods: to develop this intervention, we collaborated with a multidisciplinary advisory team, including two patient partners with lower back pain, researchers, clinicians, healthcare administrators, and the Choosing Wisely Canada lead for Saskatchewan. For this qualitative study, data were collected through two advisory team meetings, two individual interviews with lower back pain patient partners, and three focus groups with lower back pain patient participants. A lower back pain prescription pad was developed as an outcome of these consultations. Results: participants reported a lack of interactive and informative communication was a significant barrier to receiving appropriate care. The most cited content information for inclusion in this intervention was treatments known to work, including physical activity, useful equipment, and reliable sources of educational material. Participants also suggested it was important that benefits and risks of imaging were explained on the pad. Three key themes derived from the data were also used to guide development of the intervention: (a) the role of imaging in LBP diagnosis; (b) the impact of the patient-physician relationship on LBP diagnosis and treatment; and (c) the lack of patient awareness of Choosing Wisely Canada and their recommendations. Conclusions: the lower back pain patient-developed prescription pad may help patients and clinicians engage in informed conversations and shared decision making that could support reduce unnecessary lower back pain imaging.
Keywords: lower back pain; patient engagement; patient education; physician-patient relation; Choosing Wisely Canada; diagnostic imaging; primary healthcare lower back pain; patient engagement; patient education; physician-patient relation; Choosing Wisely Canada; diagnostic imaging; primary healthcare

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MDPI and ACS Style

Madani Larijani, M.; Dumba, C.; Thiessen, H.; Palen, A.; Carr, T.; Vanstone, J.R.; Fourney, D.R.; Hartness, C.; Parker, R.; Groot, G. Development of a Patient-Oriented Intervention to Support Patient-Provider Conversations about Unnecessary Lower Back Pain Imaging. Int. J. Environ. Res. Public Health 2021, 18, 2786. https://doi.org/10.3390/ijerph18052786

AMA Style

Madani Larijani M, Dumba C, Thiessen H, Palen A, Carr T, Vanstone JR, Fourney DR, Hartness C, Parker R, Groot G. Development of a Patient-Oriented Intervention to Support Patient-Provider Conversations about Unnecessary Lower Back Pain Imaging. International Journal of Environmental Research and Public Health. 2021; 18(5):2786. https://doi.org/10.3390/ijerph18052786

Chicago/Turabian Style

Madani Larijani, Maryam, Cindy Dumba, Heather Thiessen, Angie Palen, Tracey Carr, Jason R. Vanstone, Daryl R. Fourney, Collin Hartness, Robert Parker, and Gary Groot. 2021. "Development of a Patient-Oriented Intervention to Support Patient-Provider Conversations about Unnecessary Lower Back Pain Imaging" International Journal of Environmental Research and Public Health 18, no. 5: 2786. https://doi.org/10.3390/ijerph18052786

APA Style

Madani Larijani, M., Dumba, C., Thiessen, H., Palen, A., Carr, T., Vanstone, J. R., Fourney, D. R., Hartness, C., Parker, R., & Groot, G. (2021). Development of a Patient-Oriented Intervention to Support Patient-Provider Conversations about Unnecessary Lower Back Pain Imaging. International Journal of Environmental Research and Public Health, 18(5), 2786. https://doi.org/10.3390/ijerph18052786

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