Prognostic indicators for non-recovery of non-traumatic complaints at arm, neck and shoulder in general practice--6 months follow-up
Rheumatology (Oxford, England) , Volume 46 - Issue 1 p. 169- 176
OBJECTIVES: To identify predictors of non-recovery in non-traumatic complaints at the arm, neck and shoulder in general practice 6 months after the first consultation. METHODS: A prospective cohort study was set in 21 Dutch general practices. Consulters with a first or new episode of non-traumatic arm, neck or shoulder complaints and age 18 through 64 yrs entered the cohort. Complaint, patient, physical, psychosocial and work characteristics were investigated as possible predictors of non-recovery at 6 months using multiple logistic regression analyses (backward Wald). RESULTS: At 6 months, 46% of the total population (n = 612) and 42% of the working subpopulation (n = 473) still reported complaints. Complaint characteristics (long duration of the complaint before consultation, recurrent complaint, musculoskeletal comorbidity and complaint mainly located at wrist or hand) were most predictive of non-recovery followed by psychosocial characteristics (more somatization and experiencing less social support). Having a specific diagnosis was associated with recovery. In the working subpopulation, the same variables were predictors of non-recovery. Additionally, low supervisory support was associated with non-recovery. The models correctly classified 72-75% of the patients (explained variance 0.27-0.28). CONCLUSIONS: Besides questions on complaint characteristics, information on somatization and support can help a general practitioner to recognize patients at risk of persistent complaints.
|Rheumatology (Oxford, England)|
|Free full text at PubMed|
|Organisation||Erasmus MC: University Medical Center Rotterdam|
Feleus, A, Bierma-Zeinstra, S.M, Miedema, H.S, Verhagen, A.P, Nauta, A.P, Burdorf, A, … Koes, B.W. (2007). Prognostic indicators for non-recovery of non-traumatic complaints at arm, neck and shoulder in general practice--6 months follow-up. Rheumatology (Oxford, England), 46(1), 169–176. doi:10.1093/rheumatology/kel164