Abstract
To describe treatment and referral patterns and National Health Service resource use in patients with chronic pain associated with low back pain or osteoarthritis, from a Primary Care perspective. Osteoarthritis and low back pain are the two commonest debilitating causes of chronic pain, with high health and social costs, and particularly important in primary care. Understanding current practice and resource use in their management will inform health service and educational requirements and the design and optimisation of future care. Multi-centre, retrospective, descriptive study of adults (⩾18 years) with chronic pain arising from low back pain or osteoarthritis, identified through primary care records. Five general practices in Scotland, England (two), Northern Ireland and Wales. All patients with a diagnosis of low back pain or osteoarthritis made on or before 01/09/2006 who had received three or more prescriptions for pain medication were identified and a sub-sample randomly selected then consented to an in-depth review of their medical records (n=264). Data on management of chronic pain were collected retrospectively from patients' records for three years from diagnosis ('newly diagnosed' patients) or for the most recent three years ('established' patients). Patients received a wide variety of pain medications with no overall common prescribing pattern. GP visits represented the majority of the resource use and 'newly diagnosed' patients were significantly more likely to visit their GP for pain management than 'established' patients. Although 'newly diagnosed' patients had more referrals outside the GP practice, the number of visits to secondary care for pain management was similar for both groups. This retrospective study confirmed the complexity of managing these causes of chronic pain and the associated high resource use. It provides an in-depth picture of prescribing and referral patterns and of resource use.
Highlights
The International Association for the Study of Pain defines chronic pain as ‘pain that has Downloaded from https://www.cambridge.org/core
The management of chronic pain represents a significant burden to the National Health Service (NHS); it has been estimated that chronic pain accounts for 4.6 million general practice appointments in the United Kingdom each year, at a cost of £69 million, equivalent to 793 full-time general practitioners (GPs) (Belsey, 2002)
This study aimed to describe the management of patients with OA and chronic low back pain (LBP) in real-world primary care practice and to quantify the NHS resource utilisation associated with the management of these conditions
Summary
The International Association for the Study of Pain defines chronic pain as ‘pain that has Downloaded from https://www.cambridge.org/core. The management of chronic pain represents a significant burden to the National Health Service (NHS); it has been estimated that chronic pain accounts for 4.6 million general practice appointments in the United Kingdom each year, at a cost of £69 million, equivalent to 793 full-time general practitioners (GPs) (Belsey, 2002). Osteoarthritis (OA) and low back pain (LBP) contribute significantly to the number of people in the United Kingdom with chronic pain, together accounting for more than half of all cases (Elliott et al, 1999) and with the ageing population, the burden is likely to increase over the coming years. This study aimed to describe the management of patients with OA and chronic LBP in real-world primary care practice and to quantify the NHS resource utilisation associated with the management of these conditions
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