Choice of management options for low back pain: A vignette-based study in general practitioners

The interventions are known as behavioural 'nudging' interventions. In this trial the behavioural 'nudge' refers to subtle changes to the way management options are presented on a computer screen. Each participant is exposed to 4 vignettes by following a link to an online survey. The vignettes present a short case study of a person with low back pain. After reading the vignette participants will be taken to a screen where they are asked to choose from one of six management options by clicking a box next to the option. All participants receive the same six management options for a given vignette. Management options are a combination of guideline concordant (e.g. simple medicines) and guideline discordant options (e.g. opioid medicines) and vary according to the vignette. The only difference between trial arms is how the options are presented on the computer screen. Each trial arm has the menu of management options displayed differently. There are four trial arms a participant could be randomised to. The menu for Intervention Group 1 will include 3 guideline concordant options listed vertically (these are 'default' options) and discordant options which are only displayed after clicking an additional button on screen. The menu for Intervention Group 2 will include guideline discordant options listed horizontally rather than vertically. The menu for Intervention Group 3 will include guideline concordant options presented as default options and guideline discordant options listed horizontally. The survey is self-adminstered online, takes approximately 15 minutes, and is completed once only. The online survey software (Qualtrics) remind participants who fail to complete survey questions. A recruitment company will monitor those who enrol in the study but do not complete the survey.