[Back pain: do we follow the recommendations in the guidelines?]
M T Muntión-Alfaro1, M Benítez-Camps, J M Bordas-Julve
1EAP Gòtic, ICS, Barcelona, Spain.
Objective:
To describe how patients with back pain are usually handled at a health centre.
Design:
Retrospective, descriptive study.
Setting:
Urban health centre.
Participants:
All patients seen for back pain in the centre's general medical consultations during 2003.
Main Measurements:
Patients' personal details, clinical characteristics of back pain (alarm signals), semiological data, request for further tests, treatments prescribed, referral to specialists.
Results:
Five hundred and thirty eight clinical histories were included. 53.2% of patients were women, and 33.6% were over 55. 35% of patients were not questioned on pain characteristics; and in over half the cases (54.6%), there were no questions on the presence of alarm signals, either. Only in 0.6% of cases was any analogical visual scale used to assess pain. Only 46.8% of the x-rays taken were thought to be well indicated, in terms of pre-established criteria. Total rest was not normally advised (1.9%); the drugs most commonly prescribed were NSAIDs (39.6%).
Conclusions:
Clinical evaluation of patients with back pain is still inadequate in our centre, and x-rays are requested without adherence to formal or explicit criteria. We prescribe more NSAIDs than paracetamol for therapy.
