The influence of socio-demographic characteristics on consultation for back pain--a review of the literature

Joy Adamson, Kate Hunt, Irwin Nazareth, Joy Adamson, Kate Hunt, Irwin Nazareth

Abstract

Background: There are several assumptions within clinical practice about who is more or less likely to consult a health care practitioner for particular symptoms, most commonly these focus around socio-demographic characteristics. We aimed to assess the evidence for the impact of socio-demographic characteristics on consultation for back pain.

Methods: We conducted a review of the literature, using systematic methods, on consultation for back pain. Using systematic searching techniques we identified peer-reviewed publications that focused on health care consultation in response to symptoms of back pain and which included data on both users and non-users of health care.

Results: We identified 23 studies. Definitions of help-seeking were inconsistent across studies. The majority of the 15 studies which considered the relationship between age and help-seeking for back pain did not find evidence of an association between these two factors. Seventeen studies considered whether socio-economic position was associated with help-seeking. The evidence largely supported the conclusion of no association (13 papers). Fifteen studies included gender as a variable in their analyses, and the majority (10 papers) presented the finding of no association.

Conclusions: The results from this review suggest that there is little evidence to support the common wisdom that socio-demographic characteristics impact on help-seeking in the context of back pain. As these assumptions relating to who is more or less likely to consult will ultimately affect patient care, it is important that they do not go unchallenged.

Figures

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FIGURE 1
Progress of search for relevant papers

References

    1. Tudor Hart J. The inverse care law. Lancet. 1971;1:405–12.
    1. Greenhalgh T, Robert G, Bate P, et al. A Systematic Review of the Literature on Diffusion, Dissemination and Sustainability of Innovations in Health Service Delivery. London: NHS SDO Programme; 2004.
    1. Banks I. No man's land: men, illness and the NHS. BMJ. 2001;323:1058–60.
    1. Bowling A, Bond M, McKee D, et al. Equity in access to exercise tolerance testing, coronary angiography, and coronary artery bypass grafting by age, sex and clinical indications. Heart. 2001;85:680–6.
    1. Bond M, Bowling A, McKee D, Kennelly M, et al. Is age a predictor of access to cardiac services? J Health Serv Res Policy. 2003;8:40–7.
    1. McCormick A, Fleming D, Charlton J. Morbidity Statistics from General Practice. Fourth National Study 1991-1992. OPCS Series MB5 no.3. London: HMSO; 1995.
    1. Hunt K, Ford G, Harkins L, Wyke S. Are women more ready to consult than men? Gender differences in family practitioner consultation for common chronic conditions. J Health Serv Res Policy. 1999;4:96–100.
    1. Williamson J, Stokoe IH, Gray S, et al. Old people at home their unreported needs. Lancet. 1964;283:1117–20.
    1. Sanders C, Donovan JL, Dieppe PA. Unmet need for joint replacement: a qualitative investigation of barriers to treatment among individuals with severe pain and disability of the hip and knee. Rheumatology. 2004;43:353–7.
    1. Walters K, Iliffe S, Orrell M. An exploration of help-seeking behaviour in older people with unmet needs. Fam Pract. 2001;18:277–82.
    1. Dixon A, Le Grand J, Henderson J, Murray R, Poteliakhoff E. Is the British National Health Service equitable? The evidence on socioeconomic differences in utilization. J Health Serv Res Policy. 2007;12:104–9.
    1. Dixon-Woods M, Kirk D, Agarwal S, et al. Vulnerable Groups and Access to Health Care: A Critical Interpretive Review. London, UK: Report for the National Co-ordinating Centre for NHS Service Delivery and Organsation R&D (NCCSDO), 2005.
    1. Maniadakis N, Gray A. The economic burden of back pain in the UK. Pain. 2000;84:95–103.
    1. Croft PR, Macfarlane GJ, Papageorgiou AC, Thomas E, Silman AJ. Outcome of low back pain in general practice: a prospective study. BMJ. 1998;316:1356–9.
    1. Biering-Sorensen F. A prospective study of low back pain in a general population. III. Medical service–work consequence. Scand J Rehabil Med. 1983;15:89–96.
    1. Deyo RA, Tsui-Wu YJ. Descriptive epidemiology of low-back pain and its related medical care in the United States. Spine. 1987;12:264–8.
    1. Walsh K, Cruddas M, Coggon D. Low back pain in eight areas of Britain. J Epidemiol Community Health. 1992;46:227–30.
    1. Wright D, Barrow S, Fisher AD, Horsley SD, Jayson MIV. Influence of physical, psychological and behavioural factors on consultations for back pain. Br J Rheumatol. 1995;34:156–61.
    1. Hillman M, Wright A, Rajaratnam G, Tennant A, Chamberlain MA. Prevalence of low back pain in the community: implications for service provision in Bradford, UK. J Epidemiol Community Health. 1996;50:347–52.
    1. Baker D, Taylor H. Inequality in health and health service use for mothers of young children in south west England. J Epidemiol Community Health. 1997;51:74–9.
    1. Molano SM, Burdorf A, Elders LA. Factors associated with medical care-seeking due to low-back pain in scaffolders. Am J Ind Med. 2001;40:275–81.
    1. Baker D, Mead N, Campbell S. Inequalities in morbidity and consulting behaviour for socially vulnerable groups. Br J Gen Pract. 2002;52:124–30.
    1. Ijzelenberg W, Burdorf A. Patterns of care for low back pain in a working population. Spine. 2004;29:1362–8.
    1. Walker BF, Muller R, Grant WD. Low back pain in Australian adults. Health provider utilization and care seeking. J Manipulative Physiol Ther. 2004;27:327–35.
    1. Picavet HSJ, Stuijs JN, Westert GP. Utilization of health resources due to low back pain. Spine. 2008;33:436–44.
    1. Lindal E, Uden A. Why do people seek medical advice for back pain: a comparison of consulters and nonconsulters. Clin J Pain. 1989;5:351–8.
    1. VonKorff M, Wagner EH, Dworkin SF, Saunders KW. Chronic pain and use of ambulatory health-care. Psychosom Med. 1991;53:61–79.
    1. Carey TS, Evans A, Hadler N, et al. Care-seeking among individuals with chronic low back pain. Spine. 1995;20:312–7.
    1. Szpalski M, Nordin M, Skovron ML, Melot C, Cukier D. Health care utilization for low back pain in Belgium. Influence of sociocultural factors and health beliefs. Spine. 1995;20:431–42.
    1. Carey TS, Evans AT, Hadler NM, et al. Acute severe low back pain. A population-based study of prevalence and care-seeking. Spine. 1996;21:339–44.
    1. Waxman R, Tennant A, Helliwell P. Community survey of factors associated with consultation for low back pain. BMJ. 1998;7175:1564–7.
    1. Hurwitz EL, Morgenstern H. The effect of comorbidity on care seeking for back problems in the United States. Ann Epidemiol. 1999;9:262–70.
    1. Mortimer M, Ahlberg G. MUSIC-Norrtalje Study Group. To seek or not to seek? Care-seeking behaviour among people with low-back pain. Scand J Public Health. 2003;31:194–203.
    1. Ijzelenberg W, Burdorf A. Impact of musculoskeletal co-morbidity of neck and upper extremities on healthcare utilisation and sickness absence for low back pain. Occup Environ Med. 2004;61:806–10.
    1. Cote P, Baldwin ML, Johnson WG. Early patterns of care for occupational back pain. Spine. 2005;30:581–7.
    1. Alexopoulos EC, Tanagra D, Konstantinou E, Burdorf A. Musculoskeletal disorders in shipyard industry: prevalence, health care use, and absenteeism. BMC Musculoskelet Disord. 2006;7:88.
    1. Mannion AF, Tamcam O, Eisenring C, et al. The influence of patients' beliefs on their care-seeking behaviour for low back pain. Eur J Pain. 2006;10(suppl S1):S107–8.
    1. Higgins JPT, Green S, editors. Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.1 [Updated September 2008]. The Cochrane Collaboration. 2008. . (accessed on 28 January 2009)
    1. Kuorinka I, Jonsson B, Kilbom A, et al. Standardised Nordic questionnaires for the analysis of musculoskeletal symptoms. Appl Ergon. 1987;18:233–7.
    1. Antman EM, Lau J, Kupelnick B, Mosteller F, Chalmers TC. A comparison of results of meta-analyses of randomized control trials and recommendations of clinical experts: treatments for myocardial infarction. JAMA. 1992;268:240–8.
    1. Smith LK, Pope C, Botha JL. Patients' help-seeking experiences and delay in cancer presentation: a qualitative synthesis. Lancet. 2005;366:825–31.
    1. Calnan M, Wainwright D, O'Neill C, Winterbottom A, Watkins C. Illness action rediscovered: a case study of upper limb pain. Sociol Health Illn. 2007;29:321–46.
    1. Dingwall R. Aspects of Illness. London: Martin Robertson; 1976.
    1. Pescosolido B. Beyond rational choice: the social dynamics of how people seek help. Am J Sociol. 1992;97:1096–138.
    1. Mechanic D. Correlates of physician utilization: why do major multivariate studies of physician utilization find trivial pyschosocial and organizational effects? J Health Soc Behav. 1979;20:387–96.

Source: PubMed

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