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The course and prognosis of hip complaints in general practice
Johanna M van der Waal1, Sandra D M Bot, Caroline B Terwee
1EMGO Institute, VU University Medical Center, 1081 BT Amsterdam, The Netherlands.
Background:
The general practitioner needs to discriminate complaints with need of specialist care from those that can be managed in primary care. However, no previous research has studied prognostic indicators for the course of hip complaints in a primary care population.
Purpose:
The purpose of this study was to investigate the course of hip complaints presented in general practice and to identify relevant prognostic indicators of outcome.
Methods:
Data were collected by means of self-administered questionnaires containing questions about sociodemographic variables, characteristics of the complaints, and several intraindividual and extraindividual factors, including several psychosocial variables (e.g., pain coping, distress, and kinesiophobia). After 3 and 12 months of follow-up perceived recovery, change in pain intensity and change in functioning were assessed. Multiple regression analyses were performed to investigate the association between the potential prognostic indicators and the 3 outcome measures.
Results:
We included 139 patients with hip complaints, presented in general practice. Only 24% reported recovery after 3 months, increasing to 37% after 12 months. A history of hip complaints, a longer duration of the current episode of hip complaints, or more severe complaints, were associated with a less favorable prognosis. Furthermore, more vital patients and patients who met the Norm for Healthy Activity had a higher probability of a favorable outcome. Pain transformation and worrying were significant associated with recovery and changes in functioning after 3 months.
Conclusions:
Different prognostic indicators were found to be associated with perceived recovery, changes in pain intensity, and changes in functioning. Future research should aim at investigating the mechanisms that can underlie these associations.
