ArticleBMJ open2023
General practitioners' decision-making process to prescribe pain medicines for low back pain: a qualitative study.
Article in BMJ open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 11 citations in OpenAlex.
- How the Reclassification of Gabapentinoids Reshaped Neuropathic Pain Treatment in Saudi Arabia: A Survey of Healthcare Professionals.Pain and therapy · 2026Article
- Changes in Pregabalin Dispensing to Australians with Workers' Compensation Claims for Low Back Pain Following the Listing of Pregabalin on the Pharmaceutical Benefits Scheme.Journal of occupational rehabilitation · 2026Article
- General practitioners' decision-making strategies in the pharmacological treatment of musculoskeletal pain: A qualitative interview study.The European journal of general practice · 2025Article
- Association between blood cortisol levels and numerical rating scale in prehospital pain assessment.Communications medicine · 2025Article
- Lower back pain prevalence and experiences in civil service workers, Botswana.African journal of primary health care & family medicine · 2025Article
- General practitioners' experiences of managing low back pain in primary care in Ireland: A qualitative phenomenological study.PloS one · 2025Article
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Authors and funding
11 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPain medicines are widely prescribed by general practitioners (GPs) when managing people with low back pain (LBP), but little is known about what drives decisions to prescribe these medicines.
objectivesThe aim of this study was to investigate what influences GPs' decision to prescribe pain medicines for LBP.
designQualitative study with in-depth interviews.
settingAustralian primary care.
participantsWe interviewed 25 GPs practising in Australia experienced in managing LBP (mean (SD) age 53.4 (9.1) years, mean (SD) years of experience: 24.6 (9.3), 36% female). GPs were provided three vignettes describing common LBP presentations (acute exacerbation of chronic LBP, subacute sciatica and chronic LBP) and were asked to think aloud how they would manage the cases described in the vignettes. DATA ANALYSIS: We summarised GP's choices of pain medicines for each vignette using content analysis and used framework analysis to investigate factors that affected GP's decision-making.
resultsGPs more commonly prescribed opioid analgesics. Anticonvulsants and antidepressants were also commonly prescribed depending on the presentation described in the vignette. GP participants made decisions about what pain medicines to prescribe for LBP largely based on previous experiences, including their own personal experiences of LBP, rather than guidelines. The choice of pain medicine was influenced by a range of clinical factors, more commonly the patient's pathoanatomical diagnosis. While many adhered to principles of judicious use of pain medicines, polypharmacy scenarios were also common. Concerns about drug-seeking behaviour, adverse effects, stigma around opioid analgesics and pressure from regulators also shaped their decision-making process.
conclusionsWe identified several aspects of decision-making that help explain the current profile of pain medicines prescribed for LBP by GPs. Themes identified by our study could inform future implementation strategies to improve the quality use of medicines for LBP.
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