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Patient profile - a descriptive study of the patient profile in patients referred to physiotherapy in primary care in Denmark. Methods and results Nils-Bo.

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Presentation on theme: "Patient profile - a descriptive study of the patient profile in patients referred to physiotherapy in primary care in Denmark. Methods and results Nils-Bo."— Presentation transcript:

1 Patient profile - a descriptive study of the patient profile in patients referred to physiotherapy in primary care in Denmark. Methods and results Nils-Bo de Vos Andersen PT, Inger Qvist PT; Flemming Pedersen PT; Jesper Ottosen PT, Marianne Kongsgaard PT, MHP; Christine Ib PT; David. Hoyrup Christiansen PT,MHsc. Primary Health Care Physiotherapy The Regions in Denmark/ Danish Physiotherapy Association

2 Methods Descriptive cross-sectional study Descriptive cross-sectional study All patients, referred to physiotherapy by general practitioner because of musculoskeletal disorders in the period January 2012 to May 2012, were invited to participate in the study. All patients, referred to physiotherapy by general practitioner because of musculoskeletal disorders in the period January 2012 to May 2012, were invited to participate in the study. A total of 201 physical therapist in 30 clinics collected clinical data and questionnaire at encounter, using an already existing database FysDB A total of 201 physical therapist in 30 clinics collected clinical data and questionnaire at encounter, using an already existing database FysDB Inclusion criteria: Inclusion criteria: - Patients had to be over 18 years - Patients had to be over 18 years - Able to speak and understand Danish - Able to speak and understand Danish - No referral to home care - No referral to home care - Not receiving physiotherapy for the same problem within the last 3 months - Not receiving physiotherapy for the same problem within the last 3 months

3 Clinical data and questionaire Diagnostic coding: Symptom of musculoskeletal system was registered in accordance with the Danish version of the International Classification of Primary Care 2nd Edition (ICPC-2).   The Standard Evaluation Questionnaire: Pain and functional level in different body regions, duration, frequency, location, intensity (0-10) of the pain, sleep disorders (0-100), pain during daily activities, loss of function daily activities   Orebro Musculoskeletal Pain Screening Questionnaire: Fear avoidance behavior (0-30), Coping (0-10).   Mental Health Scale (SF 36): Mental wellbeing (0-100)   EQ-5D-5L Index: Health-related quality of life ( )   Health related factors: Smoking, BMI and physical activity

4

5 Did not meet inclusion criteria n= 736:  Age < 18 år (n=402)  Language (n= 155)  Phys. within <3 month (n=164)  Referred for home treatment (n=15) Invited to participate in the study n= Referred from General Practitioner N= Did not want to paticipate n=1.603 Wish to participate in the study n= (67 %) Qustionaires missing = 508  Clinical (n= 148)  Questionaire (n= 259)  Both (n=101) Included in the study n= (57 %) Results

6 . Results ICPC-2 DK Classification (n=2773) % Columna/chest Neck (L01) 21.4 Low back (L03) 25.8 Back/chest (L02/L04) 7.3 Total54.5 Upper extremities Shoulder (L08) 11.8 Arm/hand (L09-L12) 4.9 Total16.7 Lower extremities Hip(L13)4.7 Knee (L015) 6.9 Thigh/lower leg/foot(L014/16/17) 8.0 Total19.6 Other7.8 Missing1.4

7 Results 66 % women and 34 % men. 66 % women and 34 % men. Average age: 48 years Average age: 48 years No difference in gender in the 4 Regions of DK No difference in gender in the 4 Regions of DK 51 % indicated to have had one or more previous episodes of the same problem 51 % indicated to have had one or more previous episodes of the same problem 17% had undergone a previous surgery relevant to their current pain 17% had undergone a previous surgery relevant to their current pain 0.8% indicated by the physiotherapist to have possible specific serious pathology/ red flags 0.8% indicated by the physiotherapist to have possible specific serious pathology/ red flags 9.2% reported on sick leave. 9.2% reported on sick leave. 5 % have a current claim of damages 5 % have a current claim of damages

8 Results Duration: Duration: 24% acute (< 1 month.), 28% subacute (1-3 month.) 48% cronic/longstanding (>3 month.), (29% > 12 month.) Pain: 37% reported constant pain, 51 % daily pain Pain level: Mean pain level 6.6 (SD 2.2) Medicine: 40 % take daily painkillers Medicine: 40 % take daily painkillers Sleep: 46% reported having sleep disturbance because of the pain Sleep: 46% reported having sleep disturbance because of the pain n (%) Pain spreading: n (%) No body regions 135 (4,9) No body regions 135 (4,9) 1-2 body regions 1365 (49,7) 1-2 body regions 1365 (49,7) 3-4 body regions 906 (33,0) 3-4 body regions 906 (33,0) 5-7 body regions 342 (12,4) 5-7 body regions 342 (12,4)

9 Fear avoidance, Coping and Mental health   Fear avoidance beliefs   Mean score 15.8 (SD 8.3)   72% had a score indicating moderate to high levels of fear avoidance beliefs - no differences in gender, but elderly patients tend to have lower levels of fear avoidance   Coping   Mean score 4.6 (SD 2.8).   60% had a score indicating moderate to severe difficulties, to manage pain - no difference in gender and age. Mental health Functional limitations

10 Preliminary longitudinal results

11 Summary of keypoints and perspectives This is the first study profiling patients referred to physiotherapy in primary practice in Denmark. This is the first study profiling patients referred to physiotherapy in primary practice in Denmark. Patients referred to physiotherapy were characterized by: Patients referred to physiotherapy were characterized by: Female Female Chronic and recurrent pain Chronic and recurrent pain Bothered by pain from multiple body regions Bothered by pain from multiple body regions Sleeping disturbance Sleeping disturbance Fear avoidance beliefs Fear avoidance beliefs Low coping with the pain Low coping with the pain Affected mental health Affected mental health These parameters seem to be important indicators of physiotherapy assessment and treatment in primary practice. These parameters seem to be important indicators of physiotherapy assessment and treatment in primary practice. Physiotherapists in primary practice may play an important role to prevent permanent disability and chronicity by supporting patients in remaining active through advice / guidance and appropriate treatment strategies Physiotherapists in primary practice may play an important role to prevent permanent disability and chronicity by supporting patients in remaining active through advice / guidance and appropriate treatment strategies

12 Summary of keypoints and perspectives Knowing the patientprofile, we intend to analyse collected longitudinal data and registerdata in order to understand the possible prognosis of these patients Knowing the patientprofile, we intend to analyse collected longitudinal data and registerdata in order to understand the possible prognosis of these patients Enhance physiotherapist knowledge and abilities in order to identifing and stratifiing patients with a possible poor prognosis Enhance physiotherapist knowledge and abilities in order to identifing and stratifiing patients with a possible poor prognosis Improve communication in primary care between, physiotherapist and general practitioners, and also municipal communities, and second care sector Improve communication in primary care between, physiotherapist and general practitioners, and also municipal communities, and second care sector Promote a development of ongoin longitudinal datacollection in primary care physiotherapy, integrating into national databases Promote a development of ongoin longitudinal datacollection in primary care physiotherapy, integrating into national databases


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