Abstract
BackgroundBack pain is a common, disabling and costly disorder for which patients often consult with a wide range of health practitioners. Unfortunately, no research to date has directly examined the association between the severity of back pain and back pain sufferers’ choice of whom and in what order to consult different health practitioners.MethodsThis is a sub-study of the large nationally representative Australian Longitudinal Study on Women’s Health (ALSWH). The mid-age cohort women (born 1946-51, n = 13,715) of the ALSWH were recruited from the Australian national Medicare database in 1996. These women have been surveyed six time, with survey 6 being conducted in 2010 (n = 10,011). Mid-age women (n = 1851) who in 2010 had sought help from a health care practitioner for their back pain were mailed a self-report questionnaire targeting their previous 12 months of health services utilisation, health status and their levels of back pain intensity.ResultsA total of 1620 women were deemed eligible and 1310 (80.9 %) returned completed questionnaires. Mid-age women with back pain visited various conventional, allied health and CAM practitioners for care: 75.6 % consulted a CAM practitioner; 58.4 % consulted a medical doctor; and 54.2 % consulted an allied health practitioner. Women with the most severe back pain sought conventional care from a general practitioner, and those who consulted a general practitioner first had more severe back pain than those who consulted another practitioner first. Following the general practitioner visit, the women with more severe back pain were more likely to be referred to a conventional specialist, and those with less severe back pain were more likely to be referred to a physiotherapist.ConclusionsOur findings suggest that women with more severe back pain are likely to visit a conventional practitioner first, whereas women with less severe back pain are likely to explore a range of treatment options including CAM practitioners. The improvement of back pain over time following the various possible sequencing of consultations with different types of health practitioners is a topic with implications for ensuring safe and effective back pain care and worthy of further detailed investigation.
Highlights
Back pain is a common, disabling and costly disorder for which patients often consult with a wide range of health practitioners
The main questionnaire item used in the analyses was the order in which the women consulted each health care practitioner for their back pain
There were 116 women who were excluded from the analyses due to inconsistencies in their response to this question, leaving a total sample size of 1194
Summary
Back pain is a common, disabling and costly disorder for which patients often consult with a wide range of health practitioners. No research to date has directly examined the association between the severity of back pain and back pain sufferers’ choice of whom and in what order to consult different health practitioners. Back pain severity shows substantial influence in individuals’ choice of health care consultations and treatments. A previous randomized controlled trial found only patients with moderate or severe baseline pain intensity was associated with the reductions in mean back pain intensity via taking tapentadol [7]. A clinical practice guideline strongly recommended all health care practitioners to assess the severity of baseline pain when diagnosing and treating back pain as the diverse medications used have different benefits for patients with varied severity of back pain [9]
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