"A tool to support, not replace": patient and general practitioner perceptions of digital decision support tools for back pain.

BACKGROUND: Back pain is the leading musculoskeletal reason for visits in general practice. Time constraints on consultations affect diagnostic decisions and the delivery of evidence-based care. This study explored patient and general practitioner (GP) perspectives on digital tools to support decision-making in back pain management. METHODS: We conducted separate focus groups between June and August 2024 with people experiencing back pain and with registered Australian GPs. We analyzed data using thematic analysis with an inductive approach. RESULTS: We interviewed 23 participants: 13 with back pain and 10 GPs. Patients appreciated digital decision-support tools for increasing knowledge and clarifying persistent questions after consultations. GPs, in contrast, emphasized red flag screening, symptom monitoring, and time savings. Shared concerns included information trustworthiness, lack of personalization, and cost, while facilitators included integration into practice management systems and GP endorsement. CONCLUSIONS: Our findings highlight opportunities to integrate digital decision-support tools at multiple points in GPs' workflows-before, during, and after consultations-to address the needs of both patients with back pain and GPs. When used before consultations, such tools can help patients prepare by increasing their knowledge, supporting more productive discussions, informing decisions about whether a visit is necessary, and assisting GPs in identifying potential red flags. During consultations, the tools can provide clinicians with updates on current evidence and supply educational resources or prescriptions, particularly for evidence-based lifestyle interventions. After consultations, they can support follow-up by monitoring the patient's condition and addressing any persistent questions that may arise.