Influence of low back pain characteristics on the healthcare procedures prescribed by general practitioners for adult patients: ancillary analysis of the French ECOGEN study

Non-specific low back pain is a frequent reason for consultation, yet little is known about how general practitioners manage it in France. To describe the healthcare procedures general practitioners prescribe for low back pain in France. This is an ancillary analysis of an observational, cross-sectional study (ECOGEN) conducted between November 2011 and April 2012 among 128 general practitioners. Adults younger than 65 years consulting for low back pain were included. Patient and general practitioner characteristics, consultation results (diagnosis) and healthcare procedures were collected and coded using the International Classification in Primary Care. Analyses focused on the initial or follow-up consultation, adjusting on age, gender, and socio-occupational category. Out of 11510 consultations, 845 (7.3%) were for low back pain. Of these, 776 (79.5%) resulted in a clinical examination, 634 (73.4%) in medication prescription, and 203 (23.9%) were prescribed sick leave, but imaging and specialist referral were rare. Imaging was more frequent with radiating pain (adjusted odds ratio (aOR) = 1.61; 95% CI [1.07, 2.42]), as were specialist referrals (OR = 2.92; 95% CI [1.40, 6.09]) and sick leave prescription (aOR = 1.52; 95% CI [1.10, 2.09]), but physiotherapist referral was less frequent (aOR = 0.55; 95% CI [0.38, 0.82]). Clinical examinations (aOR = 2.75; 95% CI [1.98, 3.80]), imaging (aOR = 1.61; 95% CI [1.02, 2.31]) and medication prescriptions (aOR = 2.34; 95% CI [1.65, 3.30]) were more common in initial consultations, but specialist referral (aOR = 0.16; 95% CI [0.05, 0.47]) or sick leave prescription (aOR = 0.68; 95% CI [0.48, 0.97]) were rarer. Low back pain characteristics could influence healthcare procedures more markedly than patient or general practitioner characteristics. Les douleurs lombaires non spécifiques sont un motif fréquent de consultation, mais on en sait peu sur la manière dont les médecins généralistes gèrent ces plaintes. Décrire les soins prodigués ou prescrits par les médecins généralistes en France pour les douleurs lombaires. Il s'agit d'une analyse secondaire de l'étude ECOGEN, une étude observationnelle et transversale menée entre novembre 2011 et avril 2012 auprès de 128 médecins généralistes. Étaient inclus les adultes de moins de 65 ans qui consultaient pour des douleurs lombaires. Les caractéristiques des patients et des praticiens, le résultat de la consultation (diagnostics) et les soins prodigués ou prescrits étaient c