Chronic low back pain: non-clinical factors impacting on management by Irish doctors.

INTRODUCTION: General practitioners and consultants in the Republic of Ireland manage patients with chronic low back pain (LBP), but little is known about the non-clinical factors that impact on their management. AIM: To establish the non-clinical factors that impact on the management of chronic LBP by a cohort of general practitioners and consultants. METHODS: Using a multiple case study design, semi-structured interviews were conducted with general practitioners (n = 7) and consultants (n = 7). Interviews were transcribed and analysed qualitatively. RESULTS: Two main themes emerged: policy factors (the health care system, the medico-legal system), and patient factors (need for reassurance, lack of patient adherence). CONCLUSIONS: These factors operate at national and local levels. Nationally, they underscore the lack of resources, and the impact of the medico-legal system. Local issues include changing practice by reassuring patients using evidence-based biopsychosocial strategies to maximise patient care and reduce healthcare costs.