The Influence of Low Back Pain Characteristics on Healthcare Procedures Prescribed by General Practitioners for Adult Patients: A Subgroup Analysis of the French ECOGEN Study.
BACKGROUND: Nonspecific low back pain is a common reason for seeking medical care, yet little is known about how general practitioners manage it in France. OBJECTIVES: To describe the healthcare procedures general practitioners prescribe for low back pain in France. MATERIALS AND METHODS: This is a secondary 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 outcomes (diagnosis), and healthcare interventions were collected and coded using the International Classification in Primary Care. Analyses focused on the initial or follow-up consultation, adjusting for age, gender, and socio-occupational category. RESULTS AND DISCUSSION: Out of 11,510 consultations, 845 (7.3%) were for low back pain. Of these, 776 (79.5%) resulted in a clinical examination, 634 (73.4%) in a medication prescription, and 203 (23.9%) were prescribed sick leave, but imaging and specialist referrals were rare. Imaging was more frequent in cases of 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 prescriptions (aOR = 1.52; 95% CI [1.10, 2.09]), but referrals to a physical therapist were 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: Characteristics of low back pain may influence healthcare procedures more significantly than patient or general practitioner characteristics.
Author(s): Peurois Matthieu, Bouton Céline, Bègue Cyril, Fouquet Natacha, Adjeroud Najia, Raber Cécile, Ramond-Roquin Aline
Publishing year: 2022
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