Major-Helsloot Mel E, Crous Lynette C, Grimmer-Somers Karen, Louw Quinette A
Physiotherapy division, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 19063, Tygerberg, 7505 Cape Town, South Africa ; European School of Physiotherapy, Amsterdam University of Applied Sciences/Hogeschool van Amsterdam, PO Box 2557, 1000 CN Amsterdam, the Netherlands.
Physiotherapy division, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 19063, Tygerberg, 7505 Cape Town, South Africa.
Afr Health Sci. 2014 Sep;14(3):698-706. doi: 10.4314/ahs.v14i3.28.
Primary Health Care (PHC) is well suited for management of low back pain (LBP). Prevalence of (chronic) LBP is suspected to be high among visitors of the South African primary care centers, but currently no information exists on prevalence or guideline adherence.
To establish if treatment received for LBP in public PHC in the Cape Town area compares with international evidence based guidelines.
Cluster randomization determined the 8 community health centres where the study took place. A measurement tool was developed and validated for this population. Descriptive analysis and logistic regression analytical techniques were applied.
489 participants (mean age: 44.8) were included in this study. Lifetime prevalence was 73.2% and 26.3% suffered from chronic low back pain (CLBP) . Pain medication was the only form of treatment received by 90% of the sample. Interventions received seemed to be unrelated to type of LBP (acute, sub acute and chronic). Referral to physiotherapy, education and advice to stay active were rarely done. Participants expressed low satisfaction with treatment.
Current management of LBP at PHC level appears to be ineffective and not conform guidelines. Further South African research should focus on barriers as well as measures to be taken for implementation of LBP guidelines.
初级卫生保健（PHC）非常适合管理下腰痛（LBP）。据推测，南非初级保健中心的就诊者中（慢性）下腰痛的患病率很高，但目前尚无关于患病率或指南遵循情况的信息。
确定开普敦地区公共初级卫生保健机构中针对下腰痛所提供的治疗与国际循证指南相比情况如何。
采用整群随机化确定了开展该研究的8个社区卫生中心。针对该人群开发并验证了一种测量工具。应用了描述性分析和逻辑回归分析技术。
本研究纳入了489名参与者（平均年龄：44.8岁）。终生患病率为73.2%，26.3%患有慢性下腰痛（CLBP）。90%的样本仅接受了止痛药物这一种治疗形式。所接受的干预措施似乎与下腰痛的类型（急性、亚急性和慢性）无关。很少进行转介至物理治疗、提供教育以及建议保持活动。参与者对治疗的满意度较低。
初级卫生保健层面目前对下腰痛的管理似乎无效且不符合指南。南非未来的研究应聚焦于实施下腰痛指南的障碍以及需采取的措施。
