Patients' use of physical therapy for lower back pain: A qualitative study.

Only 40 participants completed interviews from 188 invited, and the sample was mostly White, non-Hispanic, college or postgraduate educated, working full time, and married or living with a partner, so it may not represent other groups. Non-English speakers and patients not offered the RapidAccess program were excluded. Forty percent did not know or were unsure they were asked about the program, which limited understanding of active decision-making in that group. The study was done in one United States health system with commercial insurance and a specific RapidAccess pathway, so findings may not transfer to other systems. Interviews were not always completed before a provider visit, and some patients had multiple back pain episodes or unclear first provider choices. The primary investigator was a physical therapist, and the team included members involved with the program, which could influence data collection and interpretation. No patient input was included in designing the interview guide. The study reports experiences and themes, not measured outcomes or evidence that physical therapy works.

The study was funded by the University of Utah’s Imagine Perfect Care seed funding program. One author received support from the Foundation for Physical Therapy Research and from VA programs at the Durham VA Health Care System during dissemination. The funders had no role in design, conduct, or reporting. The authors declared no competing interests.

Do not conclude that patients avoided physical therapy because they thought it was ineffective or disliked it. The interviews showed many wanted a physician diagnosis first, did not remember being offered physical therapy, or worried about repeated copays, and the study did not test physical therapy outcomes.