Care-seeking behaviour of adolescents with patellofemoral pain: a retrospective cohort study.

Michael Skovdal Rathleff,Sten Rasmussen,Martin Bach Jensen,Ewa M Roos,Alessandro Andreucci,Jens Lykkegaard Olesen,Camilla Rams Rathleff

doi:10.12688/f1000research.75667.1

Michael Skovdal Rathleff, Sten Rasmussen + Show 5 more

Open Access

https://doi.org/10.12688/f1000research.75667.1

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Abstract

The aim of this study was to assess the care-seeking behaviour among adolescents with patellofemoral pain (PFP). This retrospective study included data on 121 adolescents with PFP enrolled in a randomized controlled trial. A questionnaire was sent to the general practitioner (GP) of each adolescent, assessing information on the consultation dates for knee pain, potential diagnoses, and treatment provided. 106/121 adolescents had been in contact with their GP, and 95 medical records of adolescents were available. Of the 95 adolescents with available medical records 60 had consulted their GP for knee pain. The median number of contacts was 1.5 (range 1-7). The GPs initiated treatment for 48 of the 60 adolescents and in most cases it was information and advice (36/48) or pain medication to a minor extent (6/48). Out of the 60 adolescents who consulted their GP 26 were subsequently referred to different types of health care professionals, in 11 out of 26 to physiotherapy, but also to the department of rheumatology or orthopaedics. Conclusions : 63% of adolescents diagnosed with PFP had previously consulted their GP due to knee pain. Several types of treatments were initiated by the GP, but most commonly advice and information were given. Standardized and evidence-based treatment guidelines for adolescent knee pain in general practice are needed.

Highlights

Seeking medical care The questionnaires based on the general practitioner (GP) medical record showed that 60/95 (0.63, 95%CI: 0.53-0.72) of the adolescents had sought medical care for their knee pain and 30/60 (0.50, 95%CI: 0.38-0.62) had consulted their GP more than once because of knee pain, Figure 1
There was good agreement between the information provided by adolescents regarding prior consultations and the information retrieved from the medical records at the GP
These findings demonstrate the need for initiatives addressing both the adolescents and the GPs to ensure early standardised and evidence-based treatment of adolescent patellofemoral pain (PFP)

Summary

Introduction

Musculoskeletal pain is experienced by up to 40% of adolescents[1,2,3] and is a common reason for consulting a general practitioner (GP), who is often the first healthcare professional involved in the management and treatment of pain.[4,5,6] The knee is one of the most prevalent regions of reported pain.[2,7,8,9] The prevalence of knee pain in adolescents is between 19 and 31%2,8,10,11 with patellofemoral pain (PFP) being one of the most common knee conditions among adolescents, experienced by approximately 6-7% of them.[6,12,13,14] Patellofemoral pain is defined as pain in the peri- or retro-patellar area experienced during activities that involve bending of the knee (cycling, climbing stairs or similar activities). Issues associated with long-standing PFP include high pain intensity and low quality of life. Long standing PFP is associated with higher risk of interrupting participation in sport activities.[12,15]

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