Doctor-patient concordance and patient initiative during episodes of low back pain

• Published in: British journal of general practice Vol. 50; no. 459; pp. 809 - 810
• Main Authors: Hermoni, D, Borkan, J M, Pasternak, S, Lahad, A, Van-Ralte, R, Biderman, A, Reis, S
• Format: Journal Article
• Language: English
• Published: England 01.10.2000
• Subjects: Cohort Studies; Complementary Therapies; Data Collection; Family Practice; Female; Humans; Low Back Pain - therapy; Male; Middle Aged; Patient Acceptance of Health Care; Patient Participation; Physician-Patient Relations; Referral and Consultation; Treatment Outcome
• ISSN: 0960-1643; 1478-5242

Doctor-patient concordance and patient initiative were examined in a prospective network interview study, with telephone follow-up, of a cohort of 100 patients presenting with low back pain to their family physician. The average overall rate of concordance was 60% (95% CI = 53 to 66), with the highest rates for radiographic imaging studies and sick leave. No correlation was found between concordance and patient parameters. Subjects initiated an average of two (95% CI = 1.7 to 2.3) diagnostic or therapeutic procedures, the most common of which were for medications (40%), followed by bed rest (26%) and back school (22%). One out of every six subjects initiated a referral to a complementary therapist. Positive correlation was found between patient initiatives and pain severity (P = 0.022) and disability (P = 0.02). There was a negative correlation between the subjects' initiatives and their belief that the physician understood the cause of their pain and its influence on their life (P = 0.02). Overall, those patients who described more pain or disability sought more types of diagnostic and therapeutic measures, while those who felt they had been understood sought less.