Abstract
BackgroundA large proportion of people living with hip or knee pain do not consult health care professionals. Pain severity is often believed to be the main reason for help seeking in this population; however the evidence for this is contradictory. This study explores the importance of several potential risk factors on help seeking across different practitioner groups, among adults living with chronic hip or knee pain in a large community sample.MethodsHealth care utilization, defined as having seen a family doctor (GP) during the past 12 months; or an allied health professional (AHP) or alternative therapist during the past 3 months, was assessed in a community based sample aged 35 or over and reporting pain in hip or knee. Adjusted odds ratios were determined for social deprivation, rurality, pain severity, mobility, anxiety/depression, co-morbidities, and body mass index.ResultsOf 1119 persons reporting hip or knee pain, 52% had pain in both sites.Twenty-five percent of them had seen a doctor only, 3% an AHP only, and 4% an alternative therapist only. Thirteen percent had seen more than one category of health care professionals, and 55% had not seen any health care professional. In the multivariate model, factors associated with consulting a GP were mobility problems (OR 2.62 (1.64-4.17)), urban living (OR 2.40 (1.14-5.04) and pain severity (1.28 (1.13-1.44)). There was also some evidence that obesity was associated with increased consultation (OR 1.72 (1.00-2.93)). Factors were similar for consultation with a combination of several health care professionals. In contrast, seeing an alternative therapist was negatively associated with pain severity, anxiety and mobility problems (adjusting for age and sex).ConclusionDisability appears to be a more important determinant of help-seeking than pain severity or anxiety and depression, for adults with chronic pain in hip or knee. The determinants of seeking help from alternative practitioners are different from determinants of consulting GPs, AHPs or a combination of different health care providers.
Highlights
A large proportion of people living with hip or knee pain do not consult health care professionals
This study, examines the importance of several potential risk factors on help seeking across different practitioner groups, among people living with chronic hip or knee pain in a large community sample
Health care utilization data was completed by 1119 of the participants with hip or knee pain, representing 41% of those examined 7.5 years earlier, and 49% of those known to be alive at the time of the second examination (Figure 1)
Summary
A large proportion of people living with hip or knee pain do not consult health care professionals. This study explores the importance of several potential risk factors on help seeking across different practitioner groups, among adults living with chronic hip or knee pain in a large community sample. Recent studies have revealed that severe pain and greater self-reported disability were not associated with consultation of health care professionals [6,10]. Most studies define help-seeking as consultation with any health practitioner, rather than separating out the different kinds of practitioners used and definitions of joint pain do not always differentiate between acute and chronic conditions. This study, examines the importance of several potential risk factors on help seeking across different practitioner groups, among people living with chronic hip or knee pain in a large community sample
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