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Background: Low back pain is the leading worldwide cause of years lost to disability and the problem is worsening. This paper describes and demonstrates the scholarly development and contextual refinement of a primary care program for acute low back pain in Sydney, Australia. Methods: Hybrid theoretical frameworks were applied, and co-design was used to contextualise the program to the local healthcare setting. Results: The program was developed in four stages. In stage 1, the scientific evidence about management of acute low back pain in primary care was examined. In stage 2, stakeholders (patients and clinicians) were consulted in nationwide surveys. Data from stages 1 and 2 were used to design an initial version of the program, called My Back My Plan. Stage 3 involved the contextual refinement of the program to the local setting, MQ Health Primary Care. This was achieved by co-design with primary care clinicians and patients who had sought care for low back pain at MQ Health Primary Care clinics. In stage 4, a panel of Australian experts on clinical care for low back pain reviewed the contextualised version of My Back My Plan and final amendments were made. Conclusion: My Back My Plan has been developed using an innovative scholarly approach to intervention development. Low back pain is the leading worldwide cause of years lost to disability and the problem is worsening. Our study aimed to develop and test a low-cost, high-value, scalable primary care treatment program for acute low back pain. The 'My Back My Plan' program has been developed using an innovative scholarly approach to intervention development, including co-design with consumers and clinicians, and optimises provision of integrated clinical care that is individualised and person-centred. [ABSTRACT FROM AUTHOR]

Low back pain (LBP) is the highest cause of years lived with a disability in Australia and the most frequent musculoskeletal condition for which patients seek primary care. The aims of this study were to: (1) evaluate the current practices and perspectives of Australian GPs and physiotherapists managing acute back pain; and (2) explore alignment of care with clinical guidelines. This was a prospective cross-sectional Internet survey conducted from March 2018 to May 2018 of experienced Australian GPs and physiotherapists. Descriptive statistics were used to analyse all quantitative outcomes. Two hundred primary care practitioners (72% physiotherapists and 28% GPs) from all States and Territories of Australia completed the survey. Most primary care practitioners were familiar with clinical guidelines for acute back pain management and reported delivery of many of the core components of guideline-based care, including education, advice about favourable prognosis, encouraging activity and self-management and discouraging prolonged bed rest. Deviations from guideline-based care were common, including provision of analgesic medication, passive therapies and using radiological imaging. Australian primary care clinicians in this sample were aware of back pain guidelines and typically implement care that is consistent with guideline-based recommendations. Divergences from these guidelines may indicate that primary care practitioners are delivering evidence-based and person-centred care that integrates clinicians' judgement with patients' preferences and guideline-based evidence. Low back pain (LBP) is the most burdensome condition globally and experts have recently advocated for clinicians to deliver high-value care based on clinical guidelines. However, the current practices and perspectives of primary care practitioners delivering care for acute LBP in Australia are unknown. This study found that when managing acute back pain, most GPs and physiotherapists included key components of guideline-based care, although a person-centred approach often required alternative management strategies. [ABSTRACT FROM AUTHOR]