ReviewEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2026
Factors influencing referral decisions for patients with chronic low back pain: a scoping review.
Review in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
0 citing papers in PubMed.
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Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeChronic low back pain (CLBP) is a leading cause of disability worldwide, requiring coordinated referrals across different healthcare services. Despite clinical guidelines emphasising a biopsychosocial approach, referral decisions are often unstructured and poorly understood. Existing research has mainly focused on clinical management, with limited attention to the factors influencing referral decisions and their impact on referral pathways. The objective of this scoping review is to map the existing literature on factors influencing referral decisions for patients with non-specific CLBP and identify gaps for future research.
methodsFollowing PRISMA-ScR guidelines and Joanna Briggs Institute guidance for scoping reviews, a comprehensive literature search was conducted across the PubMed, EMBASE, and Web of Science databases. Studies focusing on referral decisions for patients with CLBP were included. Data extraction and descriptive synthesis were performed.
resultsThe search yielded 4,816 records, with 13 studies meeting inclusion criteria. Included studies, conducted between 1996 and 2025, spanned Europe, North America, and Israel, and comprised diverse designs including qualitative interviews, surveys, experimental vignettes, cross-sectional and cohort studies. Referral decisions in CLBP care were influenced by an interplay of clinical, psychosocial, patient-related, healthcare professional-related, systemic and contextual factors.
conclusionThis scoping review highlights the multifactorial nature of referral decisions in CLBP care and identifies critical gaps in current research. Future prospective studies are needed to better understand these factors and referral pathways, aiming to improve guideline adherence, patient outcomes, and equity in CLBP management.
Indexed as
Identifiers
42053790What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.