A systematic scoping review of patient health outcomes and perceptions following management of low back pain via care pathways in primary health care

Background Emerging evidence suggests that although care pathways for people with low back pain (LBP) improve health outcomes, there is a limited adoption/uptake of these pathways in primary care. To help identify and/or explain barriers and facilitators to implementation, research study designs applying a mixed methods approach including robust qualitative methodology may provide a more comprehensive understanding of patient health outcomes and patient perceptions of care. Methods A systematic search of MEDLINE, OVID EMBASE, Cumulative Index to Nursing and Allied Health Literature and Scopus (1980–2020) was conducted to identify relevant mixed methods, quantitative and qualitative studies. Results Three hundred and sixteen articles were screened for inclusion, with a total of 12 articles (1 mixed methods and 11 quantitative) included in the review. No solely qualitative studies were found. Broadly, patients reported overall improved health outcomes and higher satisfaction using the care pathway. In the mixed methods study, engaging patients in aspects of care were reported to be challenging. Further, while patient health outcomes (quantitative) and patient experiences of the care pathway (qualitative—free‐text survey responses) were presented separately, a lack of detailed convergence/triangulation of the data limits conclusions that could inform implementation into clinical settings. Conclusion Data supported the positive effect of care pathways on patient health outcomes, yet investigation of the patient experience was limited. Only one study used a mixed methods design and then only used free‐text survey responses for the qualitative component. Future efforts to integrate LBP care pathways into primary care may benefit from using mixed methods design with an emphasis on robust qualitative methodology.