| Popis: |
Low back pain (LBP) is a common condition presenting in primary care. It represents a significant health and economic burden. The findings from this thesis have shed new light onto the efficacy of commonly used interventions such as over-the-counter medicines, prescription opioid analgesics, muscle relaxants and advice for the management of LBP. Muscle relaxants, NSAIDs, rubefacients and local heat application are effective in the management of acute LBP, whilst opioid analgesics have shown some benefit on pain (but not disability) in chronic LBP. The findings also show that pain relief at opioid analgesic doses beyond the maximum recommended, is not likely to be clinically significant. This thesis has also identified a need among pharmacists for decision support tools to assist them in the management and triage of people with LBP. Given the findings from the simulated patient study, the tools must serve to promote evidence-based non-pharmacological management of LBP since this was an area that was broadly lacking. Encouraging effective counselling around appropriate self-care advice will also help strengthen the management of LBP in primary care. In conclusion, greater focus on LBP education at the undergraduate or postgraduate pharmacy training level may serve to bridge the knowledge and practice gaps identified. |
