Persistent non-specific low back pain (PNS-LBP) is a common problem in UK primary care. The NICE guidelines (May 2009) present a number of options for its management including conventional, complementary/alternative, and combined physical and psychological treatments. These guidelines in particular were somewhat controversial and guidelines in general are often not fully implemented in practice.
This project explores primary health care practitioners’ (HCPs) responses to the NICE guidelines. In addition, health psychology theory suggests patients’ beliefs about treatment are important determinants of uptake of and ongoing adherence to treatment. However research has tended to focus on patients’ beliefs about specific treatment in isolation (e.g. medicines), rather than exploring patients’ beliefs about all of the treatments included in the guidelines. In order to test hypotheses about the role of treatment beliefs in the uptake of and adherence to treatments in LBP, a reliable and valid questionnaire that measures patients’ beliefs about multiple treatments is needed. This project uses an exploratory sequential mixed methods design to 1) explore HCPs’ and patients’ attitudes towards, experiences of, and beliefs about recommended treatments for PNS-LBP, 2) develop a new concise questionnaire that can measure patients’ beliefs about a range of PNS-LBP treatments, 3) Establish the questionnaire’s acceptability and psychometric characteristics (face validity, construct validity, internal consistency, convergent and divergent validity, test-retest reliability); 4) Develop a preliminary brief version of the questionnaire for use in clinical practice and/or clinical trials to identify patient preferences; and 5) Test whether there is common-sense coherence between patients’ illness perceptions and treatment beliefs.
Funding: NIHR School for Primary Care Research (£57,568)
Felicity Bishop (Associate Professor)
Alex Dima
Nadine Foster
Paul Little CBE (Professor of Primary Care Research)
Rona Moss-Morris