scholarly journals Low Back Pain in Primary Care: A Description of 1250 Patients with Low Back Pain in Danish General and Chiropractic Practice

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Lise Hestbaek ◽  
Anders Munck ◽  
Lisbeth Hartvigsen ◽  
Dorte Ejg Jarbøl ◽  
Jens Søndergaard ◽  
...  
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Low Back Pain ◽  
Back Pain ◽  
Sick Leave ◽  
Primary Healthcare ◽  
Healthcare Sector ◽  
Detailed Knowledge ◽  
Low Back ◽  
Chiropractic Practice

Study Design. Baseline description of a multicenter cohort study. Objective. To describe patients with low back pain (LBP) in both chiropractic and general practice in Denmark. Background. To optimize standards of care in the primary healthcare sector, detailed knowledge of the patient populations in different settings is needed. In Denmark, most LBP-patients access primary healthcare through chiropractic or general practice. Methods. Chiropractors and general practitioners recruited adult patients seeking care for LBP. Extensive baseline questionnaires were obtained and descriptive analyses presented separately for general and chiropractic practice patients, Mann-Whitney rank sum test and Pearson’s chi-square test, were used to test for differences between the two populations. Results. Questionnaires were returned from 934 patients in chiropractic practice and 319 patients from general practice. Four out of five patients had had previous episodes, one-fourth were on sick leave, and the LBP considerably limited daily activities. The general practice patients were slightly older and less educated, more often females, and generally worse on all disease-related parameters than chiropractic patients. All differences were statistically significant. Conclusions. LBP in primary care was recurrent, causing sick leave and activity limitations. There were clear differences between the chiropractic and general practice populations in this study.

scholarly journals Effectiveness of implementing a best practice primary healthcare model for low back pain (BetterBack) compared with current routine care in the Swedish context: an internal pilot study informed protocol for an effectiveness-implementation hybrid type 2 trial

BMJ Open ◽  
2018 ◽  
Vol 8 (4) ◽  
pp. e019906 ◽  
Author(s):  
Allan Abbott ◽  
Karin Schröder ◽  
Paul Enthoven ◽  
Per Nilsen ◽  
Birgitta Öberg
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Primary Healthcare ◽  
Best Practice ◽  
Routine Care ◽  
Healthcare Sector ◽  
Low Back ◽  
Hybrid Type ◽  
Healthcare Model

IntroductionLow back pain (LBP) is a major health problem commonly requiring healthcare. In Sweden, there is a call from healthcare practitioners (HCPs) for the development, implementation and evaluation of a best practice primary healthcare model for LBP.Aims(1) To improve and understand the mechanisms underlying changes in HCP confidence, attitudes and beliefs for providing best practice coherent primary healthcare for patients with LBP; (2) to improve and understand the mechanisms underlying illness beliefs, self-care enablement, pain, disability and quality of life in patients with LBP; and (3) to evaluate a multifaceted and sustained implementation strategy and the cost-effectiveness of the BetterBack☺ model of care (MOC) for LBP from the perspective of the Swedish primary healthcare context.MethodsThis study is an effectiveness-implementation hybrid type 2 trial testing the hypothesised superiority of the BetterBack☺ MOC compared with current routine care. The trial involves simultaneous testing of MOC effects at the HCP, patient and implementation process levels. This involves a prospective cohort study investigating implementation at the HCP level and a patient-blinded, pragmatic, cluster, randomised controlled trial with longitudinal follow-up at 3, 6 and 12 months post baseline for effectiveness at the patient level. A parallel process and economic analysis from a healthcare sector perspective will also be performed. Patients will be allocated to routine care (control group) or the BetterBack☺ MOC (intervention group) according to a stepped cluster dogleg structure with two assessments in routine care. Experimental conditions will be compared and causal mediation analysis investigated. Qualitative HCP and patient experiences of the BetterBack☺ MOC will also be investigated.DisseminationThe findings will be published in peer-reviewed journals and presented at national and international conferences. Further national dissemination and implementation in Sweden and associated national quality register data collection are potential future developments of the project.Date and version identifier13 December 2017, protocol version 3.Trial registration numberNCT03147300 Pre-results.

scholarly journals Hospital staff’s risk of developing musculoskeletal disorders, especially low back pain

2018 ◽  
Vol 57 (3) ◽  
pp. 133-139 ◽  
Author(s):  
Nataša Dernovšček Hafner ◽  
Damjana Miklič Milek ◽  
Metoda Dodič Fikfak
Keyword(s):  
Risk Factors ◽  
Low Back Pain ◽  
Back Pain ◽  
Sick Leave ◽  
Musculoskeletal Disorders ◽  
Medical Centre ◽  
Healthcare Sector ◽  
Low Back ◽  
Related Absenteeism ◽  
Health Related

Abstract Introduction Health-related absenteeism impacts individuals, companies, and society. Its consequences are reflected in the cost of benefits, substitutes, and reduced productivity. Research shows that musculoskeletal disorders (MSDs) are the most common work-related health problem reported by hospital staff. This study determines the groups at the Ljubljana University Medical Centre that are most susceptible to MSDs, especially low back pain. Methods Using data from the Health Data Centre of the Slovenian National Public Health Institute and the medical centre, this cross-sectional study analysed absenteeism among medical centre employees. The correlation between MSD / low-back pain risk factors and incidence was determined using logistic regression. An odds ratio was calculated to determine the probability of MSDs, most especially low back pain via sex, age, occupation, and education. Results Sick leave at the medical centre is higher than 5%, exceeding the Slovenian healthcare sector average. MSDs, as the main reason for absence, is significantly more frequent in women, non-medical staff, and employees with a maximum secondary school education. Among the MSDs, low back pain predominates as a reason for absence and is most frequent among nurses, midwives, and employees of 20 to 44.9 years old. Conclusion This study offers insight into the health status of medical centre employees. The high percentage of sick leave is mainly due to musculoskeletal disorders, including low back pain. This is an important basis for further monitoring and analysis of sick leave indicators and for planning systematic and continuous workplace health-promoting measures to manage ergonomic risk factors and reduce health-related absenteeism.

Avaliação de Medos, Crenças e Comportamentos de Evitação em Policiais Militares de Minas Gerais Portadores de Dor Lombar Crônica/Fear-Avoidance Assessment in Minas Gerais Military Police Agents With Low Back Pain

1970 ◽  
Vol 5 (3) ◽  
pp. 18-26
Author(s):  
Marcelo von Sperling de Souza ◽  
Maximiliano Ferreira Torres de Carvalho ◽  
Anna Florence Alves Paulino Souza ◽  
Flávia Corrêa Assumpção
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Sick Leave ◽  
Minas Gerais ◽  
Low Back ◽  
Fear Avoidance ◽  
Invasive Procedures ◽  
Military Police ◽  
Fear Avoidance Beliefs ◽  
Fear Avoidance Beliefs Questionnaire

RESUMO Objetivo: descrever os índices de medos, crenças e evitação em policiais militares portadores de dor lombar crônica, acompanhados pelo Grupo de Coluna Vertebral do Hospital da Polícia Militar de Minas Gerais (PMMG). Materiais e métodos: durante um período de três anos, estas variáveis foram medidas pelo Fear-avoidance beliefs questionnaire (FABQ) versão português-brasileira, preenchido por autorrelato. As demais variáveis utilizadas para classificação da amostra em subgrupos e comparação destes quanto aos seus escores no FABQ foram idade, sexo, histórico de procedimento invasivo de coluna, presença de radiculopatia e encaminhamento pela Junta Central de Saúde (JCS), órgão oficial de perícias médicas na PMMG. Resultados: 248 militares preencheram o questionário satisfatoriamente e foram incluídos no estudo. A média de pontuação do FABQ-Work foi de 23,18 ± 10,79, enquanto a média de pontuação do FABQ-Phys foi de 18,10 ± 6,09. Não foram encontradas diferenças significativas nos escores dos subgrupos divididos por sexo, histórico de procedimento invasivo ou presença de radiculopatia. Indivíduos com idade superior a 40 anos apresentaram maiores índices de medo e evitação para atividades físicas (FABQ-Phys). Indivíduos que se encontravam em afastamento prolongado do trabalho (encaminhados pela JCS) apresentaram maior medo e evitação tanto para atividades físicas quanto atividades de trabalho. Conclusão: estes resultados permitiram identificar características dos policias militares em risco de incapacidade prolongada, ressaltando a necessidade de medidas educativas focadas na correção de crenças errôneas sobre dor lombar crônica para um melhor prognóstico na sua reabilitação.Palavras-chave: Dor lombar, Polícia, Medo, Questionários ABSTRACTObjectives: the purpose of this study was to describe fear-avoidance levels in military police agents with chronic low back pain followed by the Spine Group of the Military Police Hospital. Materials and Methods: The Brazilian Portuguese version of the Fear-avoidance Beliefs Questionnaire (FABQ) was applied during a three-year period. Secondary variables (age, sex, history of spinal invasive procedures, presence of radiculopathy, referral from medical experts due to prolonged sick-leave) were used for subgroup analysis and FABQ mean scores comparison. Results: 248 patients filled out FABQ correctly and were included in the study. FABQ-work and FABQ-Phys means were 23.18±10.79 and 18.10±6.09, respectively. There were no differences in FABQ scores between subgroups divided by sex, invasive procedures or radiculopathy. Age subgroup comparisons revealed that older individuals (> 40-years old) showed higher FABQ-Phys scores. Individuals with prolonged sick-leave showed higher scores at both FABQ-Phys and FABQ-Work subscales. Conclusion: Our results allowed identification of variables possibly related to long-time disability in military police agents and put emphasis on the need of educational interventions in which fear-avoidance beliefs are addressed in order to improve their rehabilitation prognosis.Keywords: Low back pain, Police, Fear, Questionnaires.

PC0007 Inflammatory low back pain features at primary care

2013 ◽  
Vol 71 (Suppl 3) ◽  
pp. 724.4-725
Author(s):  
L. Myasoutova ◽  
S. Lapshina ◽  
M. Protopopov ◽  
S. Erdes
Keyword(s):  
Primary Care ◽  
Low Back Pain ◽  
Back Pain ◽  
Low Back

scholarly journals Estimating the population health burden of musculoskeletal conditions using primary care electronic health records

Rheumatology ◽  
2021 ◽  
Author(s):  
Dahai Yu ◽  
George Peat ◽  
Kelvin P Jordan ◽  
James Bailey ◽  
Daniel Prieto-Alhambra ◽  
...  
Keyword(s):  
Primary Care ◽  
Chronic Pain ◽  
Low Back Pain ◽  
Back Pain ◽  
Electronic Health Records ◽  
High Impact ◽  
Low Back ◽  
Musculoskeletal Health ◽  
Health Records ◽  
Electronic Health

Abstract Objectives Better indicators from affordable, sustainable data sources are needed to monitor population burden of musculoskeletal conditions. We propose five indicators of musculoskeletal health and assessed if routinely available primary care electronic health records (EHR) can estimate population levels in musculoskeletal consulters. Methods We collected validated patient-reported measures of pain experience, function and health status through a local survey of adults (≥35 years) presenting to English general practices over 12 months for low back pain, shoulder pain, osteoarthritis and other regional musculoskeletal disorders. Using EHR data we derived and validated models for estimating population levels of five self-reported indicators: prevalence of high impact chronic pain, overall musculoskeletal health (based on Musculoskeletal Health Questionnaire), quality of life (based on EuroQoL health utility measure), and prevalence of moderate-to-severe low back pain and moderate-to-severe shoulder pain. We applied models to a national EHR database (Clinical Practice Research Datalink) to obtain national estimates of each indicator for three successive years. Results The optimal models included recorded demographics, deprivation, consultation frequency, analgesic and antidepressant prescriptions, and multimorbidity. Applying models to national EHR, we estimated that 31.9% of adults (≥35 years) presenting with non-inflammatory musculoskeletal disorders in England in 2016/17 experienced high impact chronic pain. Estimated population health levels were worse in women, older aged and those in the most deprived neighbourhoods, and changed little over 3 years. Conclusion National and subnational estimates for a range of subjective indicators of non-inflammatory musculoskeletal health conditions can be obtained using information from routine electronic health records.

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