Physician-reported barriers to using evidence-based recommendations for low back pain in clinical practice: a systematic review and synthesis of qualitative studies using the Theoretical Domains Framework

Hall, Amanda M.; Scurrey, Samantha R.; Pike, Andrea E.; Albury, Charlotte; Richmond, Helen L.; Matthews, James; Toomey, Elaine; Hayden, Jill A.; Etchegary, Holly

doi:10.1186/s13012-019-0884-4

Table 2 Description of included studies

From: Physician-reported barriers to using evidence-based recommendations for low back pain in clinical practice: a systematic review and synthesis of qualitative studies using the Theoretical Domains Framework

Study, year Country	GP (n)	Study aim	Data source	Recommendations discussed in thematic analysis					Method rigour
Study, year Country	GP (n)	Study aim	Data source	Assessment & diagnosis (9)	Treatment referral (n = 8)	Medication (n = 2)	Activity advice (n = 7)	Imaging (n = 11)	Method rigour
Bishop 2015 [32] UK	16	To clarify the decision-making processes re: particular treatments to LBP patients	Interview	✓	✓				Moderate
Breen 2007 [33] UK	21	To examine GP attitudes to managing acute LBP as a biopsychosocial problem	Focus group (n = 3)	✓	✓		✓	✓	Moderate
Chenot 2008 [34] GER	72	To explore the acceptance of GL content and perceived barriers to implementation	Focus group		✓		✓	✓	Low
Corbett 2009 [35] UK	10	To explore the attitudes and self-reported behaviour of GPs in relation LBP GL	Interview	✓			✓	✓	Good
Crawford 2007 [36] NZ	11	To understand GPs experience in identifying and managing Yellow Flags	Interview	✓					Moderate
Dahan 2007 [37] IS	38	To identify barriers and facilitators that GPs experience when using LBP GL	Focus group (n = 4)	✓				✓	Moderate
Darlow 2014 [38] NZ	11	To explore GPs’ underlying beliefs about LBP and how these beliefs influence their management	Interview	✓			✓		Good
Espeland 2003 [39] NO	13	To understand GPs barriers to using GL and what they think affects their ordering x-rays	Focus group (n = 3)					✓	Good
French 2012 [40] AU	42	To identify the barriers and enablers to restricting use of x-rays and providing advice on remaining active	Focus group	✓			✓	✓	Good
Fullen 2008 [41] IRE	7	To understand factors that impact on GPs management of chronic LBP	Interview		✓		✓	✓	Good
Green 2015 [42] CA	10	To understand the factors that influence ordering MRI for without “red flags.”	Interview		✓			✓	Moderate
Poitras 2012 [43] CA	8	To evaluate barriers for using GL for preventing LBP disability	Interview	✓	✓	✓		✓	Good
Schers 2001 [44] NL	31	To explore factors that determine nonadherence to the LBP GL	Interview	✓	✓	✓	✓	✓	Moderate
Shye 1998 [45] USA	28	To understand nonadherence to imaging GL for LBP	Focus group (n = 4)		✓			✓	Moderate

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