A Multilevel Intervention for Low Back Pain Management in Primary Care

"The multilevel intervention includes four main components:~1\. GP training. GPs will receive training to improve their confidence in LBP guidelines, diagnostic triage and best practice. Furthermore, they will be trained to provide both general and cognitive reassurance to patients, use a stratified care strategy and improve interprofessional communication. 2. Reminders. GPs will receive regular reminders by email to reinforce the integration of high-value care into practice. 3. Patient education. GPs will reassure patients, help them understand their LBP in the initial consultation and target unhelpful beliefs about LBP. 4. Clinical pathway. The clinical pathway includes a gradual stratified care pathway based on risk factors for chronicity. The core interventions of this 3-step clinical pathway are education and self-management, individual sessions with a trained physiotherapist, and multidisciplinary group management. GPs remain free to make all clinical decisions."

In this arm, general practitioners will treat their patients as usual. They can prescribed any treatment or diagnostic tests to their patients.