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EFFICACY IN LBP MANAGEMENT: PRIMARY OR SECONDARY CARE?



Abstract

Introduction: Back pain patients have an informal record of multiple attendances as they “shop around” a triage clinic for LBP patient’s has enabled evaluation of this phenomenon via the database. All patients are given advice on the importance of some form of exercise and activity as part of managing the condition, but adherence is variable.

Method: A select query was executed on the database and over a period of 13 years 12684 patients were seen of which 8.2% have been seen more than once. Of these 7.2% were seen twice, 0.8 were seen three times and one patient had been seen five times.

Results: Extracting details from those who had two visits and completed the LBOS demonstrated no sick benefit either visit 65%, on benefit both visits 10%, altered status 10% on visit one but 15% on visits two. Patient working on all visits 48%, not working 18% altering work status between visits 18% both times. Sports on both visits 50%, none at either 22% but 20% were doing sports on visit one but on visit 2 had stopped and 9% had started sports on visit two that were not involved in visits one.

Question:

  1. This data suggests that there is a low but significant number of patients who attend twice. Although advice is to increase activity this is not always demonstrated so how had their understanding been evaluated.

  2. Why are some GP’s referring patients back with the same diagnosis?

Conclusion: If the condition is best managed in primary care alternative resources/staff should be identified who can then provide the service required.

Correspondence should be addressed to Mr J. O’Dowd, Honorary Secretary at SBPR c/o BOA, Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London, WC2A 3PE.