Author/Editor		Kersnik, Janko; Car, Josip; Švab, Igor
Title		Management of chronic low back pain in family practice
Translated title		Obravnava kronične bolečine v križu v družinski medicini
Type		članek
Source		Zdrav Vars
Vol. and No.		Letnik 44, št. 4
Publication year		2005
Volume		str. 193-8
Language		eng
Abstract		Objective: There is a paucity of data about diagnostic and therapeutic interventions used by family practitioners (FPs) in patients with chronic low back pain. The aim of the study was to investigate the decision-making of FPs in the management of these patients in Slovenia. Methods: The participants were sent a written scenario about a 57-year-old man with chronic low back pain and a questionnaire inquiring about diagnostic and therapeutic procedures used in patients with chronic low back pain. A toial of 198 (25.5%) FPs were surveyed. Results: The questionnaire was answered by 129 participants (75.4% response rate), i. e. by 16.6% of the population of Slovene family physicians. Fourty-five (35%) respondents ordered one or several diagnostic tests to substantiate the diagnosis. Ordering rates were higher for FPs with larger patients lists (p = 0.02). All FPs but one prescribed medicines for pain relief Twenty-one generic types of oral and topical analgesics from eight different groups were prescribed. Twenty-five (19.3%) FPs added topical ointment to oral medication. Bedrest for a few days was recommended by 31 (24%) FPs, and maintenance of normal daily activity by only 18 (14%). Ninetyfour (73%) FPs advised their patients to engage in regular physical exercises. Sick notes were more frequently given by FPs who worked more hours per week (p = 0.05). Conclusions: Our study showed that FPs take a very varied approach to the management of chronic low back pain. The results strongly indicate a need for adopting evidence-based guidelines for low back pain management.
Summary		Izhodišča: O diagnostičnih in terapevtskih ukrepih zdravnikov družinske medicine pri kronični bolečini v križu je malo znanega. Namen te raziskave je bil preveriti izvajanje diagnostičnih in terapevtskih ukrepov pri bolnikih s kronično bolečino v križu pri slovenskih zdravnikih družinske medicine (ZDM). Metode: Pisni opis primera 57-letnega bolnika s kronično bolečino v križu z vprašalnikom o diagnostičnih in terapevtskih ukrepih smo poslali 198 (25,5%) zdravnikom družinske medicine. Rezultati: Dobili smo 129 (75,4%) odgovorov, kar predstavlja 16,6% vseh ZDM. 45 (35%) zdravnikov družinske medicine je naročilo eno ali več diagnostičnih preiskav za potrditev diagnoze. ZDM z večjim številom registriranih bolnikov so naročili več diagnostičnih preiskav (p=0, 002). Vsi ZDM razen enega so predpisali zdravila za omilitev bolečin. Predpisali so 21 različnih zdravil iz 8 različnih skupin v oralni ali topični obliki. 25 (19,3%) zdravnikov je k oralnemu zdravilo dodalo še topično zdravilo. 31 (24%) zdravnikov je svetovalo počitek v postelji nekaj dni in le 14% je svetovalo normalne dnevne dejavnosti. 94 (73%) je svetovalo redno telesno dejavnost. ZDM z večjo tedensko kvoto delovnih ur so pogosteje predpisali zdravniško upravičeno odsotnost z dela (p=0,05). Sklep: Naša raziskava je pokazala velike razlike pri obravnavi bolnikov s kronično bolečino v križu, kar močno podpira težnjo po smernicah za vodenje kronične bolečine v križu.
Descriptors		LOW BACK PAIN FAMILY PRACTICE CHRONIC DISEASE QUESTIONNAIRES CROSS-SECTIONAL STUDIES