Pilot implementation of the Fear Reduction Exercised Early (FREE) approach to low back pain

The Fear Reduction Exercised Early (FREE) approach to acute low back pain (LBP). The FREE approach aims to assist GPs to identify and address attitudes and beliefs which may be barriers to recovery from acute LBP, explain back pain to their patients, and to provide patients with a framework which enables patients to resume normal employment and activities of daily living. General practitioner (GP) participants will be instructed in the FREE approach through an initial four-hour workshop facilitated by an experienced physiotherapist. The workshop will be supported by a booklet, a website, and a module within the practice's electronic patient management system. GPs will then practise using the approach for approximately one-month with any patients who present with acute low back pain. GPs will then attend a one-hour refresher workshop facilitated by a physiotherapist. The refresher workshop will discuss experiences of using the approach and address any barriers identified . GPs will also be provided with a novel information booklet to provide to their patients. This booklet outlines current best practice for acute LBP, supports recommendations from the GP booklet, and addresses commonly held beliefs. It encourages an active approach to managing LBP. The approachwill also be supported by a website. GPs will have access to the website throughout the study and on an ongoing basis following the study. GPs will be able to continue using the FREE approach following the four-month study period in each practice. GPs will be able to personalise the care they provide to any individual patient based on their own clinical reasoning. A purposive sample of approximately twelve patients who consult GPs who have completed FREE training with a primary complaint of acute low back pain will be interviewed as part of this study.