Jordan Kelvin, Jinks Clare, Croft Peter
Primary Care Sciences Research Centre, Keele University, Keele.
Br J Gen Pract. 2006 Apr;56(525):269-76.
Knee pain is common among older adults but only a minority consult their doctor about it.
To determine predictors of new episodes of consultation in primary care among older people with knee pain.
Population-based prospective cohort study linking baseline survey to primary care medical records.
Three general practices in North Staffordshire, UK.
Subjects were 1797 people aged > or =50 years who responded to a general population survey, reported knee pain in the previous 12 months and had no record of a knee disorder consultation in the 18 months prior to the survey. The main outcome measure was a record of a knee disorder consultation in the 18 months following the survey.
The incidence of a new episode of general practice care was approximately 10% per year. Apart from chronicity (odds ratio [OR] = 1.5; 95% confidence interval [CI] = 1.1 to 2.1), measures of pain severity were not strong influences on future consultation. No social support (measured by having no partner) increased likelihood of future consultation (OR = 1.3; 95% CI = 1.0 to 1.8). Among those with chronic and severe pain, main predictors were previous experiences of health care (use of non-GP services OR = 1.8; previous knee injury OR = 1.7). Current depression reduced likelihood of consulting about the knee problem (OR = 0.6; 95% CI = 0.3 to 0.9).
Knee pain is common in the older population but a minority consult their doctor about it. Severity of pain and disability is not a strong influence on consultation. For those more severely affected, depression may act as a barrier to healthcare use.
膝关节疼痛在老年人中很常见，但只有少数人会因此咨询医生。
确定膝关节疼痛的老年人在初级保健中出现新的咨询情况的预测因素。
基于人群的前瞻性队列研究，将基线调查与初级保健医疗记录相联系。
英国北斯塔福德郡的三家全科诊所。
研究对象为1797名年龄≥50岁的人，他们参与了一项普通人群调查，报告在过去12个月中有膝关节疼痛，且在调查前18个月内没有膝关节疾病咨询记录。主要观察指标是调查后18个月内膝关节疾病咨询记录。
每年新出现的全科医疗护理事件发生率约为10%。除了慢性疼痛（优势比[OR]=1.5；95%置信区间[CI]=1.1至2.1）外，疼痛严重程度指标对未来咨询的影响不大。缺乏社会支持（以没有伴侣衡量）增加了未来咨询的可能性（OR=1.3；95%CI=1.0至1.8）。在慢性和严重疼痛患者中，主要预测因素是既往医疗保健经历（使用非全科医生服务OR=1.8；既往膝关节损伤OR=1.7）。当前的抑郁状态降低了就膝关节问题咨询的可能性（OR=0.6；95%CI=0.3至0.9）。
膝关节疼痛在老年人群中很常见，但只有少数人会咨询医生。疼痛和残疾的严重程度对咨询的影响不大。对于那些受影响更严重的人，抑郁可能成为医疗保健利用的障碍。
