{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T13:13:40Z","timestamp":1790255620678,"version":"4.1.0"},"reference-count":31,"publisher":"BMJ","issue":"8","license":[{"start":{"date-parts":[[2023,8,30]],"date-time":"2023-08-30T00:00:00Z","timestamp":1693353600000},"content-version":"unspecified","delay-in-days":29,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004928","name":"Danske Fysioterapeuter","doi-asserted-by":"publisher","award":["A2951"],"award-info":[{"award-number":["A2951"]}],"id":[{"id":"10.13039\/501100004928","id-type":"DOI","asserted-by":"publisher"}]},{"name":"The Foundation for Advancement of Chiropractic Research and Postgraduate Education","award":["R126-A2638"],"award-info":[{"award-number":["R126-A2638"]}]},{"name":"The Foundation for Advancement of Chiropractic Research and Postgraduate Education","award":["R126-A2763"],"award-info":[{"award-number":["R126-A2763"]}]},{"DOI":"10.13039\/501100022806","name":"Fonden for Almen Praksis","doi-asserted-by":"publisher","award":["07\/18"],"award-info":[{"award-number":["07\/18"]}],"id":[{"id":"10.13039\/501100022806","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100023490","name":"IMK Almene Fond","doi-asserted-by":"publisher","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}],"id":[{"id":"10.13039\/501100023490","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2023,8,4]]},"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To explore the elements and composition of care provided by general practitioners (GPs), physiotherapists (PTs) and chiropractors (DCs) to patients with low back pain (LBP).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Observational study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Primary care setting, Denmark.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Primary care clinicians (GPs, PTs and DCs) in the Region of Southern Denmark were invited to register consecutive adult patient visits with LBP as the primary complaint.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary outcome measures<\/jats:title>\n                    <jats:p>Clinicians reported care elements provided to patients with LBP. Elements varied due to professional differences (eg, prescriptive rights). Data were descriptively analysed, on group and individual levels, for frequency and combination of care elements, and practice patterns were explored with latent class analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The clinicians (33 GPs, 67 PTs and 43 DCs with a median experience of 15 years and 59% were females) registered 3500 patient visits. On average, the visits involved patients aged 51 years, and 51% were with females. The frequencies of common care elements across professions were information (42%\u201356% of visits between professions) and advice (56%\u201381%), while other common elements for GPs were pain medication (40%) and referrals to PTs (36%), for PTs, use of exercises (81%) and for DCs, use of manual therapy (96%). Substantial variation was observed within professions and distinct practice patterns, with different focuses of attention to information and advice versus exercise and manual therapy, were identified for PTs and DCs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These data indicate substantial variation in the care elements provided by GPs, PTs and DCs to LBP patients. The compositions of care and practice patterns identified challenge the understanding of usual care as a uniform concept and professions as homogeneous groups. Strategic use of particular care elements in different parts of treatment courses is indicated. Longitudinal data and qualitative enquiry are needed to assess if or how care is tailored to individual patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2023-071602","type":"journal-article","created":{"date-parts":[[2023,8,30]],"date-time":"2023-08-30T12:15:55Z","timestamp":1693397755000},"page":"e071602","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":12,"title":["Exploring usual care for patients with low back pain in primary care: a cross-sectional study of general practitioners, physiotherapists and chiropractors"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1054-2327","authenticated-orcid":false,"given":"Simon Dyrl\u00f8v","family":"Madsen","sequence":"first","affiliation":[{"name":"Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark"},{"name":"Chiropractic Knowledge Hub, Odense, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3084-4186","authenticated-orcid":false,"given":"Lars","family":"Mors\u00f8","sequence":"additional","affiliation":[{"name":"Open Patient data Explorative Network, Odense University Hospital, Odense, Denmark"},{"name":"Department of Clinical Research, OPEN Research Unit, University of Southern Denmark, Odense, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1865-8399","authenticated-orcid":false,"given":"Werner","family":"Vach","sequence":"additional","affiliation":[{"name":"Basel Academy for Quality and Research in Medicine, Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4833-1867","authenticated-orcid":false,"given":"Merethe Kirstine","family":"Andersen","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, Department of Public Health, Research Unit of General Practice, University of Southern Denmark, Odense, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9128-6136","authenticated-orcid":false,"given":"Jesper","family":"Lykkegaard","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, Department of Public Health, Research Unit of General Practice, University of Southern Denmark, Odense, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3866-856X","authenticated-orcid":false,"given":"Berit","family":"Schi\u00f8ttz-Christensen","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, Department of Public Health, Research Unit of General Practice, University of Southern Denmark, Odense, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0297-8267","authenticated-orcid":false,"given":"Mette Jensen","family":"Stochkendahl","sequence":"additional","affiliation":[{"name":"Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark"},{"name":"Chiropractic Knowledge Hub, Odense, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,8,30]]},"reference":[{"key":"2025121509573862000_13.8.e071602.1","doi-asserted-by":"crossref","DOI":"10.21037\/atm.2020.02.175","article-title":"Global low back pain prevalence and years lived with disability from 1990 to 2017: estimates from the global burden of disease study 2017","volume":"8","author":"Wu","year":"2020","journal-title":"Ann Transl Med"},{"key":"2025121509573862000_13.8.e071602.2","unstructured":"Jensen HAR , Davidsen M , Ekholm O , et al . 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