Influence of low back pain characteristics on the healthcare procedures prescribed by general practitioners for adult patients: ancillary analysis of the French ECOGEN study.


Journal

Revue d'epidemiologie et de sante publique
ISSN: 0398-7620
Titre abrégé: Rev Epidemiol Sante Publique
Pays: France
ID NLM: 7608039

Informations de publication

Date de publication:
Jun 2022
Historique:
received: 14 09 2021
revised: 07 03 2022
accepted: 08 03 2022
pubmed: 13 4 2022
medline: 25 5 2022
entrez: 12 4 2022
Statut: ppublish

Résumé

Non-specific low back pain is a frequent reason for consultation, yet little is known about how general practitioners manage it in France. To describe the healthcare procedures general practitioners prescribe for low back pain in France. This is an ancillary analysis of an observational, cross-sectional study (ECOGEN) conducted between November 2011 and April 2012 among 128 general practitioners. Adults younger than 65 years consulting for low back pain were included. Patient and general practitioner characteristics, consultation results (diagnosis) and healthcare procedures were collected and coded using the International Classification in Primary Care. Analyses focused on the initial or follow-up consultation, adjusting on age, gender, and socio-occupational category. Out of 11510 consultations, 845 (7.3%) were for low back pain. Of these, 776 (79.5%) resulted in a clinical examination, 634 (73.4%) in medication prescription, and 203 (23.9%) were prescribed sick leave, but imaging and specialist referral were rare. Imaging was more frequent with radiating pain (adjusted odds ratio (aOR) = 1.61; 95% CI [1.07, 2.42]), as were specialist referrals (OR = 2.92; 95% CI [1.40, 6.09]) and sick leave prescription (aOR = 1.52; 95% CI [1.10, 2.09]), but physiotherapist referral was less frequent (aOR = 0.55; 95% CI [0.38, 0.82]). Clinical examinations (aOR = 2.75; 95% CI [1.98, 3.80]), imaging (aOR = 1.61; 95% CI [1.02, 2.31]) and medication prescriptions (aOR = 2.34; 95% CI [1.65, 3.30]) were more common in initial consultations, but specialist referral (aOR = 0.16; 95% CI [0.05, 0.47]) or sick leave prescription (aOR = 0.68; 95% CI [0.48, 0.97]) were rarer. Low back pain characteristics could influence healthcare procedures more markedly than patient or general practitioner characteristics.

Sections du résumé

BACKGROUND BACKGROUND
Non-specific low back pain is a frequent reason for consultation, yet little is known about how general practitioners manage it in France.
OBJECTIVES OBJECTIVE
To describe the healthcare procedures general practitioners prescribe for low back pain in France.
MATERIALS AND METHODS METHODS
This is an ancillary analysis of an observational, cross-sectional study (ECOGEN) conducted between November 2011 and April 2012 among 128 general practitioners. Adults younger than 65 years consulting for low back pain were included. Patient and general practitioner characteristics, consultation results (diagnosis) and healthcare procedures were collected and coded using the International Classification in Primary Care. Analyses focused on the initial or follow-up consultation, adjusting on age, gender, and socio-occupational category.
RESULTS AND DISCUSSION CONCLUSIONS
Out of 11510 consultations, 845 (7.3%) were for low back pain. Of these, 776 (79.5%) resulted in a clinical examination, 634 (73.4%) in medication prescription, and 203 (23.9%) were prescribed sick leave, but imaging and specialist referral were rare. Imaging was more frequent with radiating pain (adjusted odds ratio (aOR) = 1.61; 95% CI [1.07, 2.42]), as were specialist referrals (OR = 2.92; 95% CI [1.40, 6.09]) and sick leave prescription (aOR = 1.52; 95% CI [1.10, 2.09]), but physiotherapist referral was less frequent (aOR = 0.55; 95% CI [0.38, 0.82]). Clinical examinations (aOR = 2.75; 95% CI [1.98, 3.80]), imaging (aOR = 1.61; 95% CI [1.02, 2.31]) and medication prescriptions (aOR = 2.34; 95% CI [1.65, 3.30]) were more common in initial consultations, but specialist referral (aOR = 0.16; 95% CI [0.05, 0.47]) or sick leave prescription (aOR = 0.68; 95% CI [0.48, 0.97]) were rarer.
CONCLUSION CONCLUSIONS
Low back pain characteristics could influence healthcare procedures more markedly than patient or general practitioner characteristics.

Identifiants

pubmed: 35410701
pii: S0398-7620(22)00170-5
doi: 10.1016/j.respe.2022.03.001
pii:
doi:

Types de publication

Journal Article Observational Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

133-139

Informations de copyright

Copyright © 2022 The Authors. Published by Elsevier Masson SAS.. All rights reserved.

Auteurs

Matthieu Peurois (M)

Université Angers, Université Rennes, Inserm, EHESP (Ecole des Hautes Etudes en santé Publique), IRSET (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, F-49000 Angers, France; Université Angers, Département de médecine générale, F-49000 Angers, France. Electronic address: matthieu.peurois@univ-angers.fr.

Céline Bouton (C)

Université Nantes, Département de médecine générale, 44035 Nantes, France.

Cyril Bègue (C)

Université Angers, Université Rennes, Inserm, EHESP (Ecole des Hautes Etudes en santé Publique), IRSET (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, F-49000 Angers, France; Université Angers, Département de médecine générale, F-49000 Angers, France.

Natacha Fouquet (N)

Santé publique France, Univ Angers, Angers.

Najia Adjeroud (N)

Université Angers, Département de médecine générale, F-49000 Angers, France.

Cécile Raber (C)

Université Angers, Département de médecine générale, F-49000 Angers, France.

Aline Ramond-Roquin (A)

Université Angers, Université Rennes, Inserm, EHESP (Ecole des Hautes Etudes en santé Publique), IRSET (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, F-49000 Angers, France; Université Angers, Département de médecine générale, F-49000 Angers, France; Department of Family Medicine and Emergency Medicine, Université de Sherbrooke, Québec, Canada.

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Classifications MeSH