Extended report
A population study of factors associated with general
practitioner consultation for non-inflammatory musculoskeletal pain
Kåre B Hagena, Arild Bjørndala, Till Uhligb, Tore K Kvienb
a Department of
Population Health Sciences, National Institute of Public Health, Oslo,
Norway, b Oslo City Department of Rheumatology,
Diakonhjemmet Hospital, N-0319 Oslo, Norway
Correspondence to: Dr Kåre B Hagen, Health Services Research Unit, Department of Population Health Sciences, National Institute of Public Health, PO Box 4404, Torshov, N-0403 Oslo, Norway Email kare.birger.hagen{at}folkehelsa.no
Accepted for publication 7 March 2000
OBJECTIVE
To investigate factors
associated with visiting a general practitioner (GP) for
non-inflammatory musculoskeletal pain, and to examine whether these
factors were affected by duration (chronic v
non-chronic) or location (widespread v
regional) of pain.
METHODS
From a cross
sectional postal survey of 20 000 (response rate 59%) randomly
selected adults in two counties of Norway, 6408 subjects who had
experienced musculoskeletal pain during the past month were included.
Patients who reported inflammatory rheumatic diagnoses made by a doctor
were excluded.
RESULTS
2909 (45%)
had consulted a GP for their musculoskeletal pain during the past 12 months. The odds of consulting were significantly increased by being a
woman, by having a higher age and lower education, and by being a
pensioner or on sick leave. Patients with widespread pain were more
likely to consult than those with regional pain, as were patients with
chronic compared with non-chronic pain. Greater than median pain
intensity was the factor most prominently associated with consultation
for men (odds ratio (OR)=2.4; 95% confidence interval (95% CI) 2.0 to
2.9) and for women (OR=2.6; 95% CI 2.3 to 2.9). Overall, consultation
was significantly associated with mental distress for women but not for
men. Subgroup analyses showed that consultation for chronic pain was
significantly associated with greater than median mental distress for
both women (OR=1.3; 95% CI 1.1 to 1.6) and men (OR=1.2; 95% CI 1.0 to
1.4), whereas consultation for non-chronic pain was not.
CONCLUSION
The results
show that about half of the patients with musculoskeletal pain consult
a general practitioner (GP) each year, that demographic factors are
associated with consulting, and that the role of mental distress for
consulting a GP varies with duration of pain.
© 2000 by Annals of the Rheumatic Diseases
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