Does primary care management of low-back pain differ in older persons: Results from the MUSICIAN study

Marcus Beasley, Stephan Schild von Spannenberg, Gareth Jones, Gary Macfarlane

Research output: Contribution to conferenceAbstractpeer-review

Abstract

Background:
Patient-reported evidence suggests management of low back pain in primary care differs according to age, particularly older patients are more likely than younger to receive pharmacological management, either with or without other treatments.
Objective(s):
To determine from medical records whether, amongst persons with back pain visiting their general practitioner (GP), management differs with age.
Methods:
In a large-scale population-based survey, adults over 24 years were asked about current pain (and location), whether they consulted their GP, and management received. Among respondents a sample was drawn of people registered at four Aberdeen practices, reporting current back pain, visiting their GP for pain within the last year and giving permission to access records. Records were examined for consultations beginning a year before survey completion, and data extracted on pain site and GP action. Management by age was analysed by logistic regression and odds ratios with 95% Confidence Intervals (CI) were calculated.
Results:
240 patients were selected of which 144 had 456 recorded consultations for back pain. Tertiles of patient age were 25-50, 51-67 and 68-91 years. Medication was prescribed at 97 (64%) consultations in the youngest, 87 (57%) in the middle age-group (OR 0.76; 95% CI, 0.48-1.20), and 78 (51%) in the oldest (0.60; 0.38-0.95). Lifestyle advice, physical therapy or exercise were less likely to be prescribed in the oldest compared to the youngest group (17% v. 30%) OR 0.48 (0.28-0.82) while the oldest were more likely to be referred to a specialist or for investigation (28% v. 18%) OR 1.67 (0.98-2.86).

Conclusions:
Previous findings that suggested pharmacological management was more common at older ages were not supported. Older persons were however less likely to be given lifestyle advice, physical therapy or prescribed exercise. Although these observations require further study, it is important to ensure older persons are benefitting from evidence-based non-pharmacological management of back pain.
Original languageEnglish
Publication statusPublished - 2013
EventScottish Pain Research Community 3rd Annual Scientific Meeting - Dundee, United Kingdom
Duration: 28 Mar 2013 → …

Conference

ConferenceScottish Pain Research Community 3rd Annual Scientific Meeting
CountryUnited Kingdom
CityDundee
Period28/03/13 → …

Keywords

  • epidemiology
  • primary care
  • pain management
  • low back pain

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