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Methods

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

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Methods

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  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 • 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 • Inclusion criteria: - Patients had to be over 18 years - Able to speak and understand Danish - No referral to home care - 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 (0.0 -1.0) • Health related factors: Smoking, BMI and physical activity

  4. Results Referred from General Practitioner N= 5.621 • 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= 4.885 Did not want to paticipate n=1.603 Wish to participate in the study n= 3.281 (67 %) • Qustionaires missing = 508 • Clinical (n= 148) • Questionaire (n= 259) • Both (n=101) Included in the study n= 2.773 (57 %)

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  6. Results • 66 % women and 34 % men. • Average age: 48 years • No difference in gender in the 4 Regions of DK • 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 • 0.8% indicated by the physiotherapist to have possible specific serious pathology/ red flags • 9.2% reported on sick leave. • 5 % have a current claim of damages

  7. Results • 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 • Sleep: 46% reported having sleep disturbance because of the pain Pain spreading: n (%) No body regions 135 (4,9) 1-2 body regions 1365 (49,7) 3-4 body regions 906 (33,0) 5-7 body regions 342 (12,4)

  8. 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

  9. Preliminary longitudinal results

  10. Summary of keypoints and perspectives • This is the first study profiling patients referred to physiotherapy in primary practice in Denmark. • Patients referred to physiotherapy were characterized by: • Female • Chronic and recurrent pain • Bothered by pain from multiple body regions • Sleeping disturbance • Fear avoidance beliefs • Low coping with the pain • Affected mental health • 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

  11. 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 • 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 • Promote a development of ongoin longitudinal datacollection in primary care physiotherapy, integrating into national databases

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