Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway
Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway.
BMJ Open. 2021 Sep 17;11(9):e053229. doi: 10.1136/bmjopen-2021-053229.
To describe characteristics of older adults with back pain in primary care, and to assess associations between patient characteristics and type of first primary care provider (general practitioner (GP), physiotherapist (PT) or chiropractor).
Cross-sectional analysis from the Back Complaints in the Elders-Norway cohort study.
Norwegian GP, PT and chiropractic primary care centres.
Patients aged ≥55 years seeking Norwegian primary care with a new episode of back pain were invited to participate. Between April 2015 and February 2020, we included 452 patients: 127 first visited a GP, 130 first visited a PT and 195 first visited a chiropractor.
For the first objective, the outcome measure was descriptive statistics of patient characteristics, covering the following domains: sociodemographic, general health, current and previous back pain, psychological and clinical factors. For the second objective, first primary care provider was the outcome measure. Associations between patient characteristics and visiting a GP or PT compared with a chiropractor were assessed with multiple multinomial regression analyses.
Median (IQR) age was 66 (59-72) years. Levels of back-related disability was moderate to severe, with a median (IQR) Roland-Morris Disability Questionnaire (range 0-24) score of 9 (5-13). Recurring episodes were common, 301 (67%) patients had monthly or yearly recurrences. Patients with worse back-related disability, longer duration of symptoms, lower expectations for full recovery and worse physical performance measured with the Back Performance Scale had higher odds of visiting a GP or PT compared with a chiropractor (p<0.05).
Older back pain patients in primary care had moderate to severe levels of back-related disability, and most had recurring episodes. Our results suggest that older adult's choice of first primary care provider was associated with important patient characteristics, which highlights the need for caution with generalisations of study results across primary care populations.
NCT04261309.
描述初级保健中老年腰痛患者的特征，并评估患者特征与第一初级保健提供者（全科医生（GP）、物理治疗师（PT）或整脊师）类型之间的关系。
来自挪威背部疾病老年人队列研究的横断面分析。
挪威 GP、PT 和整脊初级保健中心。
邀请 55 岁及以上、因新出现腰痛而到挪威初级保健机构就诊的患者参加。在 2015 年 4 月至 2020 年 2 月期间，我们纳入了 452 名患者：127 名患者首次就诊于 GP，130 名患者首次就诊于 PT，195 名患者首次就诊于整脊师。
对于第一个目标，结果测量是患者特征的描述性统计，涵盖以下领域：社会人口统计学、一般健康状况、当前和以前的腰痛、心理和临床因素。对于第二个目标，第一初级保健提供者是结果测量。使用多变量多项回归分析评估患者特征与就诊 GP 或 PT 与就诊整脊师之间的关系。
中位数（IQR）年龄为 66（59-72）岁。腰痛相关残疾程度为中重度，Roland-Morris 残疾问卷中位数（IQR）评分（范围 0-24）为 9（5-13）。复发很常见，301 名（67%）患者每月或每年复发。腰痛相关残疾程度更差、症状持续时间更长、对完全康复的期望更低以及使用背部表现量表测量的身体表现更差的患者，与就诊整脊师相比，就诊 GP 或 PT 的可能性更高（p<0.05）。
初级保健中老年腰痛患者腰痛相关残疾程度为中重度，且多数患者有反复发作。我们的研究结果表明，老年患者对第一初级保健提供者的选择与重要的患者特征相关，这突显了在整个初级保健人群中推广研究结果时需要谨慎。
NCT04261309。
