A content analysis of online information about the benefits and harms of spine surgery

Ferreira, Giovanni E; Zadro, Joshua R; O’Keeffe, Mary; Chen, Meilin; Gao, Ying; Hu, Ziqi; Zhang, Ziyun; Harris, Ian; Maher, Christopher G.

doi:10.1016/j.bjpt.2022.100398

Cited by 4 publications

(3 citation statements)

References 27 publications

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“…We used content analysis to create a summary of GP’s choices of pain medicines prescribed for each vignette. Content analysis combines both qualitative and quantitative methods, allowing both the content and frequency of categories to be reported 14 15. Two researchers initially reviewed and familiarised themselves with the transcripts, and coded all pain medicines using the following framework: medicines that would be prescribed as first-, second-, third- or fourth-line care, medicines that GPs would conditionally prescribe (eg, depending on a patient characteristic), and those that GPs were against prescribing.…”

Section: Methodsmentioning

confidence: 99%

General practitioners’ decision-making process to prescribe pain medicines for low back pain: a qualitative study

Ferreira,

Zadro,

Jones

et al. 2023

BMJ Open

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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 analysisWe 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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Section: Methodsmentioning

confidence: 99%

General practitioners’ decision-making process to prescribe pain medicines for low back pain: a qualitative study

Ferreira,

Zadro,

Jones

et al. 2023

BMJ Open

Self Cite

View full text Add to dashboard Cite

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“…However, health information online is often non-scientific, non-evidencebased, and sometimes biased by conflicts of interests (teaching of private courses, partnerships with companies) [96]. Some studies have investigated the content analysis of online information about low back pain [97], spine surgery [98], anterior cruciate ligament [99], and health jornal infographics [100], and observed that the content is commonly not aligned with the best available evidence. Most online information does not report sufficient information to allow readers to interpret the study findings [100].…”

Section: Barriers and Challenges Of Telerehabilitation Implementationmentioning

confidence: 99%

The state of the art in telerehabilitation for musculoskeletal conditions

et al. 2023

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Background Given the rapid advances in communication technology and the need that emerged from the COVID-19 pandemic, telehealth initiatives have been widely used worldwide. This masterclass aims to provide an overview of telerehabilitation for musculoskeletal conditions, synthesizing the different terminologies used to describe telehealth and telerehabilitation, its effectiveness and how to use it in clinical practice, barriers and facilitators for the implementation in health services, and discuss the need of a curriculum education for the near future. Main body Telerehabilitation refers to the use of information and communication technologies provided by any healthcare professionals for rehabilitation services. Telerehabilitation is a safe and effective option in the management of musculoskeletal conditions in different models of delivery. There are many technologies, with different costs and benefits, synchronous and asynchronous, that can be used for telerehabilitation: telephone, email, mobile health, messaging, web-based systems and videoconferences applications. To ensure a better practice of telerehabilitation, the clinician should certify safety and access, and appropriateness of environment, communication, technology, assessment, and therapeutic prescription. Despite the positive effect of telerehabilitation in musculoskeletal disorders, a suboptimal telerehabilitation implementation may have happened due to the COVID-19 pandemic, especially in countries where telehealth was not a reality, and clinicians lacked training and guidance. This emphasizes the need to identify the necessary curriculum content to guide future clinicians in their skills and knowledge for telerehabilitation. There are some challenges and barriers that must be carefully accounted for to contribute to a health service that is inclusive and relevant to health professionals and end users. Conclusions Telerehabilitation can promote patient engagement in health care and plays an important role in improving health outcomes in patients with musculoskeletal conditions. Digital health technologies can also offer new opportunities to educate patients and facilitate the process of behavior change to a healthy lifestyle. Currently, the main needs in telerehabilitation are the inclusion of it in health curriculums in higher education and the development of cost-effectiveness and implementation trials, especially in low- and middle-income countries where access, investments and digital health literacy are limited.

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“…A recent review of 79 websites from six English-speaking countries found that much of the information on treatment recommendations was of low credibility, inaccurate and not comprehensive (Ferreira et al 2019). Similarly, a content analysis of online information about decompression and fusion surgery for spine pain found that only 25% of web pages provided an accurate description of the evidence for the benefits of spine surgery, and although 65% provided details of the potential harms of surgery, only 15% provided quantitative estimates for the mentioned harms (Ferreira et al 2022).…”

Section: Introductionmentioning

confidence: 99%

A content analysis of the interventions for low back pain promoted on the websites of Australian pain clinics

Maher,

Han,

Gilbert

et al. 2024

Aust. J. Prim. Health

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Background The Internet is a widely used source of health information, yet the accuracy of online information can be low. This is the case for low back pain (LBP), where much of the information about LBP treatment is poor. Methods This research conducted a content analysis to explore what pain treatments for LBP are presented to the public on websites of Australian pain clinics listed in the PainAustralia National Pain Services Directory. Websites providing information relevant to the treatment of LBP were included. Details of the treatments for LBP offered by each pain service were extracted. Results In total, 173 pain services were included, with these services linking to 100 unique websites. Services were predominantly under private ownership and located in urban areas, with limited services in non-urban locations. Websites provided detail on a median of six (IQR 3–8) treatments, with detail on a higher number of treatments provided by services in the private sector. Physical, psychological and educational treatments were offered by the majority of pain services, whereas surgical and workplace-focused treatments were offered by relatively few services. Most services provided details on multidisciplinary care; however, interdisciplinary, coordinated care characterised by case-conferencing was infrequently mentioned. Conclusions Most websites provided details on treatments that were largely in-line with recommended care for LBP, but some were not, especially in private clinics. However, whether the information provided online is a true reflection of the services offered in clinics remains to be investigated.

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A content analysis of online information about the benefits and harms of spine surgery

Cited by 4 publications

References 27 publications

General practitioners’ decision-making process to prescribe pain medicines for low back pain: a qualitative study

General practitioners’ decision-making process to prescribe pain medicines for low back pain: a qualitative study

The state of the art in telerehabilitation for musculoskeletal conditions

A content analysis of the interventions for low back pain promoted on the websites of Australian pain clinics

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