General practitioners’ stay-at-work practices in patients with musculoskeletal disorders: using Intervention Mapping to develop a training program

TL;DR

This study explores how Danish general practitioners handle work-related issues in patients with musculoskeletal disorders and proposes a training program to improve their involvement.

Contribution

The paper introduces a training program for GPs to enhance their role in supporting patients with musculoskeletal disorders to stay at work.

Findings

GPs' stay-at-work practices are influenced by systemic, organizational, and personal factors.

GPs often act as coaches but rely on patients or workplaces to take action.

A training program incorporating tools and behavior change techniques is proposed to address identified barriers.

Abstract

To describe current stay-at-work practices among Danish general practitioners (GPs) in relation to patients with musculoskeletal disorders, to identify potential avenues for improvement, and to suggest a training program for the GPs.

We followed the principles of Intervention Mapping. Data were collected by means of literature searches, focus group interviews with GPs, and interaction with stakeholder representatives from the Danish labour market.

GPs’ current stay-at-work practices were influenced by systemic, organisational, and legislative factors, and by personal determinants, including knowledge and skills relating to stay-at-work principles and musculoskeletal disorders, recognition of the patient’s risk of long-term work disability, their role as a GP, and expectations of interactions with other stay-at-work stakeholders. GPs described themselves as important partners and responsible for the diagnostic and holistic assessments of the patient but placed themselves on the side line relying on the patient or workplace stakeholders to act. Their practices are influenced both by patients, employers, and by other stakeholders. We propose a training course for GPs that incorporate both concrete tools and behaviour change techniques.

We have identified varied perspectives on the roles and responsibilities of GPs, as well as legislative and organisational barriers, and proposed a training program. Not all barriers identified can be addressed by a training course, and some questions are left unanswered, among others - who are best suited to help patients staying at work?

Musculoskeletal disorders are highly prevalent and one of the most common causes for visiting a GP.In many countries, GPs are important in facilitating that patients stay at work, when they are experiencing musculoskeletal pain and disability.In our research, GPs place themselves on the side line as coaches relying on the patient or workplace to act.Barriers such as role identity, systemic and organisational issues prevent GPs from being more involved in stay-at-work practices.GPs’ with knowledge about stay-at-work practices may empower patients to better self-management.

Musculoskeletal disorders are highly prevalent and one of the most common causes for visiting a GP.

In many countries, GPs are important in facilitating that patients stay at work, when they are experiencing musculoskeletal pain and disability.

In our research, GPs place themselves on the side line as coaches relying on the patient or workplace to act.

Barriers such as role identity, systemic and organisational issues prevent GPs from being more involved in stay-at-work practices.

GPs’ with knowledge about stay-at-work practices may empower patients to better self-management.

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