Physical activity advice given by French general practitioners for low back pain and the role of digital e-health applications: a qualitative study

Abstract

Abstract Background Low back pain is the fourth most common reason for consulting a general practitioner (GP) among people aged 40–50 years. Beyond the overall benefits of physical activity (PA) on health (psychological, cardiovascular, etc.), PA for low back pain seems to improve the prognosis in terms of pain, disability, and quality of life. The French National Health Insurance developed media campaigns to promote physical activity with low back pain and a smartphone application (app). Despite the known benefits and campaigns, GPs do not routinely provide advice about physical activity during low back pain consultations. To promote giving physical activity advice for low back pain, there is a need to understand how GPs currently provide this advice and whether technology could help. This study aims to explore the content of physical activity advice for low back pain that GPs provide in France, and their opinion about healthcare smartphone app provided electronically via the internet (e-health apps) as a support for this advice. Methods This qualitative study was conducted with semi-structured individual interviews among French GPs. The verbatim was double coded using a coding tree. Thematic analysis was performed using an inductive approach. Results Sixteen GPs from Maine et Loire, Sarthe, and Mayenne were included. The thematic analysis identified the following themes: GPs use a global patient-centred approach to physical activity advice for low back pain. The main goal is to enable patients to participate in their care. Advice was almost always general with little information about duration and frequency. The importance of patient-appropriate and easily achievable activities was emphasised. GPs referred patients to physiotherapists to reinforce regular physical activity, maintain motivation and improve patient adherence through supervision and follow-up. GPs knew little about e-health apps but felt they could be useful with young patients. The main barriers to their use included poor internet connection, lack of technical knowledge and no supervision meaning patients could injure themselves. Conclusions This is one of the first studies to assess the contents of physical activity advice GPs provide for low back pain. Further research is needed into the implementation of e-health apps for low back pain management. Trial registration Not applicable.