ASSESSMENT OF KNOWLEDGE, ATTITUDE AND PRACTICE OF RED FLAGS RELATED TO ACUTE LOW BACK PAIN AMONG PRIMARY HEALTH CARE PHYSICIAN, MINISTRY OF HEALTH, JEDDAH 2013-2014.

Background: Low back pain is a very common condition, about 90% of people suffering from it at some point in their lives. It is a leading cause of lost time at work and disability. For example, in the USA, it is responsible for an annual direct health care expenditure of more than $20 billion. Objectives: To assess the level of knowledge, attitude and practice of primary health care physicians, Ministry of Health regarding red flags of acute low back pain in Jeddah in 2014. Subjects and Methods: A cross-sectional study design among a representative random sample of physicians at PHC centers of Ministry of Health was adopted. Data were collected through self-administrative questionnaire included socio-demographic data, knowledge data checklists about eleven red flags of acute low back pain: prolonged use of corticosteroids, age >50 years, significant trauma, bladder dysfunction, saddle anesthesia, fever with chills or night sweat, history of malignancy, lower extremities neurological deficit, weight loss, rest or night pain and immune suppression patients and the last partcontained 12 items that assessed the consistency of respondent agreement with the COST B13 guidelines. Results: The study included 180 physicians. Approaching half of them (46.6%) was in the age group 20-30 years. Females represent 60% of them. Most of them were Saudis (77.8%). Previous education or training in relation back pain and red flags components was reported among more than half of them (51.1%) during their under-graduation whereas during post-graduation was reported by 28.9%. The first red flags of acute low back known by the primary health care physicians were Bladder dysfunction (83.9%), age over 50 years (77.2%), history of trauma (73.3%) and weight (68.9%) whereas the lowest known red flag of acute low back pain was pain less than two weeks (8.3%). Consultants had high level of knowledge more than assistant consultants, residents and general practitioners. Physicians with none previous education or training in relation to back pain and red flags components had less level of knowledge than those reported under graduate, postgraduate and continuous medical education in this regard.The total average score was (3.27) with SD± (0.57). Conclusion: The knowledge of primary health care physicians in Jeddah regarding red flags of acute back pain is satisfactory in general. However, their attitude and practice of red flags of acute low back pain is suboptimal.