Background
Many clinical practice guidelines recommend non-drug interventions (NDIs) as the first-line approach for managing common acute and chronic conditions in primary care.1 2 NDIs can be as effective, or even more effective, than some drug interventions at preventing and treating various conditions,3 4 including cardiac rehabilitation for heart disease,5 pulmonary rehabilitation for chronic obstructive pulmonary disease,6 elevating the head of the bed for gastro-oesophageal reflux symptoms,3 4 and cognitive therapy for depression, anxiety, low back pain and insomnia.1 7–9
It is crucial for primary care clinicians, such as general practitioners (GPs), to offer evidence-based healthcare by supplying patients with reliable information regarding various treatment choices, including effective NDIs. This ensures that individuals can make well-informed choices regarding their health.10
Despite this, and substantial evidence supporting the effectiveness of NDIs to manage conditions commonly seen in primary care, NDIs are not as widely known, promoted and used as their pharmacological counterparts.11 12 There are several challenges to using NDIs in primary care including awareness of NDIs, the availability of detailed ‘how-to’ information13 and ease of access to evidence-based information about effective NDIs at point-of-care.14 There is also a lack of practical information and resources to help GPs and patients to use effective NDIs. This represents a mismatch between what is known to be effective and what is predominantly used in practice, and a lack of practical resources to facilitate the use of NDIs.15 Addressing these challenges is crucial to effectively optimise the uptake of evidence-based effective NDIs in primary care.
To address this, in 2013, The Royal Australian College of General Practitioners (RACGP) developed the Handbook of Non-Drug Interventions (HANDI), which is a regularly updated online formulary of effective NDIs that mimics the format of modern drug handbooks, including information on indications, contraindications and ‘dosing’.11 Although HANDI has addressed a key barrier to using NDIs (ie, availability of practical information and resources), there are still other major barriers to using NDIs that persist among Australian GPs.
Therefore, the aims of this study were to (1) examine current attitudes, beliefs and use of NDIs, and in particular, the use of RACGP HANDI, and (2) identify barriers and enablers influencing the use of NDIs and RACGP HANDI in clinical practice among GPs in Australia.