How low back pain is managed—a mixed-methods study in 32 countries. Part 2 of low back pain in low- and middle-income countries series

Sharma, Saurab; Pathak, Anupa; Parker, Romy; Costa, Leonardo Oliveira Pena; Ghai, Babita; Igwesi-Chidobe, Chinonso; Janwantanakul, Prawit; De Jesus-Moraleida, Fabianna Resende; Chala, Mulugeta Bayisa; Pourahmadi, Mohammadreza; Briggs, Andrew M.; Gorgon, Edward; Ardern, Clare L.; Khan, Karim M.; McAuley, James H.; Alghwiri, Alia A.; Aoko, Oluwayomi Abolade; Badamasi, Habibu Salisu; Calvache, Jose A.; Cardosa, Mary Suma; Ganesh, Shankar; Gashaw, Moges; Ghiringhelli, Johanna; Gigena, Santiago; Hasan, A.T.M. Tanveer; Haq, Syed Atiqul; Ng’wiza, Jacob Emmanuel; Janse van Rensburg, Dina Christina; Kossi, Oyéné; Liu, Chang; Malani, Rinkle; Mason, Brett James Nairn; Najem, Charbel; Nava-Bringas, Tania Ines; Nduwimana, Ildephonse; Perera, Romain; Perveen, Wajida; Pierobon, Andrés; Pinto, Emília,; Pinto, Rafael Z.; Purwanto, Firmansyah; Rahimi, Mohammad Dawood; Reis, Felipe J.J.; Siddiq, Md Abu Bakar; Shrestha, Dipak; Tamang, Monu; Vasanthan, T. Lenny; Viljoen, Carel Thomas

How low back pain is managed—a mixed-methods study in 32 countries. Part 2 of low back pain in low- and middle-income countries series

Sharma, Saurab; Pathak, Anupa; Parker, Romy; Costa, Leonardo Oliveira Pena; Ghai, Babita; Igwesi-Chidobe, Chinonso; Janwantanakul, Prawit; De Jesus-Moraleida, Fabianna Resende; Chala, Mulugeta Bayisa; Pourahmadi, Mohammadreza; Briggs, Andrew M.; Gorgon, Edward; Ardern, Clare L.; Khan, Karim M.; McAuley, James H.; Alghwiri, Alia A.; Aoko, Oluwayomi Abolade; Badamasi, Habibu Salisu; Calvache, Jose A.; Cardosa, Mary Suma; Ganesh, Shankar; Gashaw, Moges; Ghiringhelli, Johanna; Gigena, Santiago; Hasan, A.T.M. Tanveer; Haq, Syed Atiqul; Ng’wiza, Jacob Emmanuel; Janse van Rensburg, Dina Christina; Kossi, Oyéné; Liu, Chang; Malani, Rinkle; Mason, Brett James Nairn; Najem, Charbel; Nava-Bringas, Tania Ines; Nduwimana, Ildephonse; Perera, Romain; Perveen, Wajida; Pierobon, Andrés; Pinto, Emília,; Pinto, Rafael Z.; Purwanto, Firmansyah; Rahimi, Mohammad Dawood; Reis, Felipe J.J.; Siddiq, Md Abu Bakar; Shrestha, Dipak; Tamang, Monu; Vasanthan, T. Lenny; Viljoen, Carel Thomas

URI: http://hdl.handle.net/2263/100256

Date: 2024-08

Abstract:

BACKGROUND: The Lancet Low Back Pain (LBP) Series highlighted the lack of LBP data from low- and middle-income countries (LMICs). The study aimed to describe (1) what LBP care is currently delivered in LMICs and (2) how that care is delivered. DESIGN: An online mixed-methods study. METHODS: A Consortium for LBP in LMICs (n = 65) was developed with an expert panel of leading LBP researchers (>2 publications on LBP) and multidisciplinary clinicians and patient partners with 5 years of clinical/lived LBP experience in LMICs. Quantitative data were analyzed using descriptive statistics. Two researchers independently analyzed qualitative data using inductive and deductive coding and developed a thematic framework. RESULTS: Forty-seven (85%) of 55 invited panel members representing 32 LMICs completed the survey (38% women, 62% men). The panel included clinicians (34%), researchers (28%), educators (6%), and people with lived experience (4%). Pharmacotherapies and electrophysiological agents were the most used LBP treatments. The thematic framework comprised 8 themes: (1) self-management is ubiquitous, (2) medicines are the cornerstone, (3) traditional therapies have a place, (4) society plays an important role, (5) imaging use is very common, (6) reliance on passive approaches, (7) social determinants influence LBP care pathway, and (8) health systems are ill-prepared to address LBP burden. CONCLUSION: LBP care in LMICs did not consistently align with the best available evidence. Findings will help research prioritization in LMICs and guide global LBP clinical guidelines.