Prevalence, diagnostics, and management of musculoskeletal disorders in primary health care in Sweden: an investigation of 2000 randomly selected patient records
2016 (English)In: Journal of Evaluation In Clinical Practice, ISSN 1356-1294, E-ISSN 1365-2753Article in journal (Refereed) Epub ahead of print
Background. To improve the care of patients suffering from musculoskeletal disorders (MSD) further knowledge regarding the prevalence, diagnostics and management of different MSD in primary care is required. Thus the aims of this study were: -to investigate the prevalence of patients seeking care due to different MSD at primary health care centres (PHCs); -to chart different factors as symptoms, diagnosis, and actions prescribed for patients that visited the PHCs due to MSD; and -to make comparisons regarding differences due to gender, age, and rural or urban PHC.
Methods. 2000 patient records for patients in working age were randomly selected equally distributed on one rural and one urban PHC. A 3-year period was reviewed retrospectively. For all patient records age, sex, occupation, occupational activity, date of visit, if it was a new or re-visit, cause to the visit, and diagnosis related to the visit were registered. For visits due to MSD the location of the patients symptoms, which symptoms were described in the patient record, the type of those symptoms, which actions were prescribed to resolve the patients problems, and also sickleave prior to and after the visit, were registered. Data was analysed using cross tabulation, multidimensional Chi-square (Pearson), and a probability level of p < .05.
Results. The prevalence of MSD was high, almost 60 % of the patients had some sort of MSD symptoms, either at the day for visit or the reviewed 3 year period, and a bit higher among women than men. Upper and lower limb problems were most common. Symptoms were most prevalent in the young and middle age-groups. The patients got a variety of different diagnoses, and between 13-35 % of the patients did not receive a MSD-diagnose despite having MSD-symptoms. There was a great variation in how the cases were handled. Medication and sick leave certificates were most common while work-related rehabilitation was less common. Conclusion. The present study points out some weaknesses regarding diagnostics and management of MSD in primary care. Further studies to compare the results regarding diagnoses for musculoskeletal symptoms and measures taken to solve the patients’ problems would be of interest.
Place, publisher, year, edition, pages
Prevalence, diagnostics, management, musculoskeletal disorders, pain, primary health care.
Environmental Health and Occupational Health
IdentifiersURN: urn:nbn:se:hig:diva-21091DOI: 10.1111/jep.12614PubMedID: 27538347ScopusID: 2-s2.0-84994681869OAI: oai:DiVA.org:hig-21091DiVA: diva2:896961