Why are there so many different guidelines? A qualitative study of the low back pain policy landscape in Australia.
- 1Leeder Centre for Health Policy, Economics and Data, Faculty of Medicine and Health, University of Sydney, Sydney, Australia. [email protected].
- 2Leeder Centre for Health Policy, Economics and Data, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.
- 3Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.
Abstract
Background
Low back pain is a major cause of disease burden around the world. The sheer number and variety of back pain guidelines developed in Australia suggests that there are drivers within the low back pain care landscape to promote development of guidelines which are produced by a wide range of actors. This has motivated us to understand the context, processes and purposes behind the development of such directives and to understand the views of researchers and clinicians on the current state of back pain care provision.Methods
We used qualitative methodology and collected data through interviews with authors and other contributors who have been involved with the preparation of low back pain directives, published in the last twenty years. The data was analysed using hybrid analytical approach with inductive and deductive methods and is reported according to the consolidated criteria for reporting qualitative studies.Results
Fifteen participants were recruited into in the study, their roles ranging from clinicians, academicians, researchers to managers. The types directives that they worked on, included MOC, guidelines and information sheets, which were published in the last 20 years. The five overarching themes are 1. Purpose behind development, 2. Process of development, 3. Challenges during development, 4A. Challenges related to back pain care provision 4B. Challenges related to the use of back pain directives, 5A. Recommendations on back pain care provision 5B: Recommendations related to back pain directives.Conclusion
Our study found that back pain directives were developed in Australia for various purposes, and the process is interjected by different challenges ranging from funding to lack of implementation. The process and challenges are intertwined by macro level factors that define the landscape of low back pain care provision. Through a secondary analysis, our study shows that macro level factors such as institutions and structures not only influence micro level behaviour of individuals and organisations, but also actions at the micro level can also have transformative effects on the macro level. The participants suggest that the way directives are developed can solve the issues around back pain care provision, incorporating strategies like improving updating methods, better involvement of consumers and changing the language used in directives.
Related
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BibTeX
@article{parambath2026there,
title = {{Why are there so many different guidelines? A qualitative study of the low back pain policy landscape in Australia.}},
author = {Sarika Parambath and Carmen Huckel Schneider and Fiona Blyth},
journal = {BMC musculoskeletal disorders},
year = {2026},
month = aug,
doi = {10.1186/s12891-026-10221-4},
url = {https://europepmc.org/article/MED/42972504},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Why are there so many different guidelines? A qualitative study of the low back pain policy landscape in Australia.
AU - Sarika Parambath
AU - Carmen Huckel Schneider
AU - Fiona Blyth
PY - 2026
DA - 2026/08/05
JO - BMC musculoskeletal disorders
DO - 10.1186/s12891-026-10221-4
UR - https://europepmc.org/article/MED/42972504
AB - Background Low back pain is a major cause of disease burden around the world. The sheer number and variety of back pain guidelines developed in Australia suggests that there are drivers within the low back pain care landscape to promote development of guidelines which are produced by a wide range of actors. This has motivated us to understand the context, processes and purposes behind the development of such directives and to understand the views of researchers and clinicians on the current state of back pain care provision.Methods We used qualitative methodology and collected data through interviews with authors and other contributors who have been involved with the preparation of low back pain directives, published in the last twenty years. The data was analysed using hybrid analytical approach with inductive and deductive methods and is reported according to the consolidated criteria for reporting qualitative studies.Results Fifteen participants were recruited into in the study, their roles ranging from clinicians, academicians, researchers to managers. The types directives that they worked on, included MOC, guidelines and information sheets, which were published in the last 20 years. The five overarching themes are 1. Purpose behind development, 2. Process of development, 3. Challenges during development, 4A. Challenges related to back pain care provision 4B. Challenges related to the use of back pain directives, 5A. Recommendations on back pain care provision 5B: Recommendations related to back pain directives.Conclusion Our study found that back pain directives were developed in Australia for various purposes, and the process is interjected by different challenges ranging from funding to lack of implementation. The process and challenges are intertwined by macro level factors that define the landscape of low back pain care provision. Through a secondary analysis, our study shows that macro level factors such as institutions and structures not only influence micro level behaviour of individuals and organisations, but also actions at the micro level can also have transformative effects on the macro level. The participants suggest that the way directives are developed can solve the issues around back pain care provision, incorporating strategies like improving updating methods, better involvement of consumers and changing the language used in directives.
SN - 1471-2474
ER -