Spine Centre of Southern Denmark, Lillebaelt Hospital, Middelfart, Denmark.
Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.
Scand J Prim Health Care. 2023 Jun;41(2):152-159. doi: 10.1080/02813432.2023.2196548. Epub 2023 May 8.
To describe and compare the demographic and clinical characteristics of patients with acute or chronic low back pain across all health care settings treating this condition. Concurrent prospective survey registration of all consecutive consultations regarding low back pain at general practitioners, chiropractors, physiotherapists, and the secondary care spine centre in Southern Denmark.
Patients ≥16 years of age with low back pain.
Demographic characteristics, symptoms, and clinical findings were registered and descriptively analysed. Pearson's chi-square tested differences between the populations in the four settings. Multiple logistic regression assessed the odds of consulting specific settings, and -test assessed differences between patients attending for a first and later consultation.
Thirty-six general practitioners, 44 chiropractors, 74 physiotherapists, and 35 secondary care Spine Centre personnel provided information on 5645 consultations, including 1462 first-visit consultations. The patients differed significantly across the settings. Patients at the Spine Centre had the most severe symptoms and signs and were most often on sick leave. Compared to the other populations, the chiropractor population was younger, whereas the physiotherapist population was older, more often females, and had prolonged symptoms. In general practice, first-time consultations were with milder cases while patients who attended for a second or later consultation had the worst symptoms, findings, and risk of sick leave compared to the other primary care settings.
The demographic and clinical characteristics of patients with low back pain differ considerably across the health care settings treating them.KEY POINTSThe study describes the symptoms and clinical findings of patients with low back pain consulting the Danish health care system in all its settings.Patients with chiropractors were youngest, while those with physiotherapists were the oldest and most frequently female.First consultations in general practice were generally with the least symptomatic patients while those returning for a subsequent consultation had more severe disease including more sick leave compared to patients in the other primary care settings.Our findings call for caution when generalizing between health care settings for patients with low back pain.
描述和比较在丹麦南部所有治疗急性或慢性下背痛的医疗保健环境中，患有急性或慢性下背痛的患者的人口统计学和临床特征。对全科医生、脊椎按摩师、物理治疗师和二级保健脊柱中心所有连续就诊的下背痛患者进行同时前瞻性调查登记。
年龄≥ 16 岁的下背痛患者。
登记人口统计学特征、症状和临床发现，并进行描述性分析。Pearson χ2 检验用于比较四个环境中的人群差异。多因素逻辑回归评估了咨询特定环境的可能性，t 检验评估了首次就诊和再次就诊患者之间的差异。
36 名全科医生、44 名脊椎按摩师、74 名物理治疗师和 35 名二级保健脊柱中心人员提供了 5645 次就诊信息，包括 1462 次首次就诊。患者在不同环境下存在显著差异。脊柱中心的患者症状和体征最严重，病假时间最长。与其他人群相比，脊椎按摩师人群更年轻，而物理治疗师人群更年长，更多为女性，且症状持续时间更长。在全科医疗中，首次就诊的患者病情较轻，而再次就诊的患者症状、体征和病假风险比其他初级保健环境中的患者更差。
治疗下背痛的医疗保健环境中，患者的人口统计学和临床特征存在显著差异。
本研究描述了在丹麦医疗保健系统所有环境中就诊的下背痛患者的症状和临床发现。
接受脊椎按摩治疗的患者年龄最小，而接受物理治疗的患者年龄最大，且女性居多。
一般来说，全科医生的首次就诊患者症状通常较轻，而再次就诊的患者病情较严重，包括病假时间更长，与其他初级保健环境中的患者相比。
我们的研究结果表明，在将下背痛患者的治疗情况从一个医疗保健环境推广到另一个医疗保健环境时需要谨慎。
