Factors defining care-seeking in low back pain – A meta-analysis of population based surveys

  1. Manuela L. Ferreira1,*,
  2. Gustavo Machado2,
  3. Jane Latimer3,
  4. Christopher Maher3,
  5. Paulo H. Ferreira1,
  6. Rob J. Smeets4,5

Article first published online: 16 JAN 2012

DOI: 10.1016/j.ejpain.2009.11.005

Issue

European Journal of Pain

European Journal of Pain

Volume 14, Issue 7, pages 747.e1–747.e7, August 2010

Additional Information

How to Cite

Ferreira, M. L., Machado, G., Latimer, J., Maher, C., Ferreira, P. H. and Smeets, R. J. (2010), Factors defining care-seeking in low back pain – A meta-analysis of population based surveys. European Journal of Pain, 14: 747.e1–747.e7. doi: 10.1016/j.ejpain.2009.11.005

Author Information

  1. 1

    Clinical and Rehabilitation Sciences Research Group, University of Sydney, Australia

  2. 2

    Physiotherapy Department, Federal University of Minas Gerais, Brazil

  3. 3

    The George Institute for International Health, Sydney, Australia

  4. 4

    Department of Rehabilitation Medicine, Caphri, Maastricht University, The Netherlands

  5. 5

    Adelante Zorggroep, Hoensbroek, The Netherlands

* Tel.: +61 2 9351 9937; fax: +61 2 9351 9601.mferreira@usyd.edu.au

Publication History

  1. Issue published online: 16 JAN 2012
  2. Article first published online: 16 JAN 2012
  3. Recevied 23 June 2009; Revised 12 November 2009; accepted 22 November 2009

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Keywords:

  • Health care-seeking behavior;
  • Health resources;
  • Low back pain;
  • Meta-analysis

Abstract

Little is known about factors determining health care-seeking behavior in low back pain. While a number of studies have described general characteristics of health care utilization, only a few have aimed at appropriately assessing determinants of care-seeking in back pain, by comparing seekers and non-seekers. The objective of this systematic review was to identify determinants of health care-seeking in studies with well-defined groups of care-seekers and non-seekers with non-specific low back pain.

A search was conducted in Medline, AMED, Cinahl, Web of Science, PsycINFO, National Research Register, Cochrane Library and LILACS looking for population- based surveys of non-specific low back pain patients older than 18 years, published since 1966. To be included in the review, studies needed to report on characteristics of well-defined groups of care-seekers and non-seekers. Methodological quality was assessed using a criteria list based on sampling, response rate, data reproducibility, power calculation and external validity. Risk estimates were expressed as odd ratios (95% confidence intervals). When possible, meta-analyses were performed, using a random effects model.

Eleven studies were included in the review. Pooled results show that women are slightly more likely to seek care for their back pain as are patients with a previous history of back pain. Pain intensity was only slightly associated with care-seeking, whereas patients with high levels of disability were nearly eight times more likely to seek care than patients with lower levels of disability.

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