BMJ 1996;312:1481 (8 June)

Letters

Research on which to base guidelines is possible in primary care

EDITOR,--Paul Little and colleagues' study shows the difficulties encountered in applying evidence of effectiveness in general practice.1 The authors question the applicability to primary care of evidence derived from another setting. What struck me, however, was that one third of the respondents rated their satisfaction with their management of back pain as </=4 out of 10 (I had thought that it might be worse than that).

This raises a few questions. Firstly, as dissatisfaction in managing a problem may reflect a self identified lack of knowledge, I would be interested to know if there was any relation between respondents' satisfaction with their management of back pain and other variables, such as level of examination, giving advice on exercise, and missing danger signs. Similarly, a perceived inability to influence the course of a disease or condition is likely to lead a doctor to have feelings of therapeutic inadequacy. This may be . . . [Full text of this article]


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Relevant Article

General practitioners' management of acute back pain: a survey of reported practice compared with clinical guidelines
Paul Little, Lisa Smith, Ted Cantrell, Judith Chapman, John Langridge, and Ruth Pickering
BMJ 1996 312: 485-488. [Abstract] [Full Text]

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