PARENTERAL USE OF ANALGESICS IN LOW BACK PAIN IN FAMILY MEDICINE

Background: Injections are not recommended due to the lack of evidence about their effectiveness and potential additional risks. We would like to know the proportion and characteristics of general practice attainders with low back pain who were treated with medications in injection. Methods: In a cross-sectional study including 12,596 consecutive attainders of general practice in 42 general practices, we analysed all the contacts due to low back pain. In a sample of attainders in the age group from 18 to 65, we analysed the proportion and factors influencing a decision for treatment with medications in injection. Results: Low back pain was the reason for attendance in 819 (6.5%) patients; 300 (2.4%) with acute and 519 (4.1%) with chronic low back pain. 132 (20.7%) patients from 18 to 65 years were treated with medications in injection. In multivariate analysis, several factors were found to be important for the decision for injection of medications: patients' characteristics (older age, lower level of education), type of pain (acute ishialgic pain) and physicians' factors (specialisation in family medicine, younger age). Differences between physicians in using injections were significant: 8 out of 42 physicians did not use injections, but there was a physician who used injections in 19 out of 32 patients (59.4%). Conclusions: Huge differences in the use of medications in injection in patients with low back pain indicate a necessity for intervention whose aim would be to reduce the differences between physicians and improve the quality and safety of patient care.