脊柱疾病患者的医疗保健使用和不康复

IF 3.4 2区医学 Q1 ANESTHESIOLOGY

European Journal of Pain Pub Date : 2025-07-28 DOI:10.1002/ejp.70074

Lise Grethe Kjønø, Marianne Bakke Johnsen, Margreth Grotle, Jan Hartvigsen, Stine Clausen, Maja Wilhelmsen, Kåre Rønn Richardsen, Kjersti Storheim, Karin Magnusson

{"title":"脊柱疾病患者的医疗保健使用和不康复","authors":"Lise Grethe Kjønø, Marianne Bakke Johnsen, Margreth Grotle, Jan Hartvigsen, Stine Clausen, Maja Wilhelmsen, Kåre Rønn Richardsen, Kjersti Storheim, Karin Magnusson","doi":"10.1002/ejp.70074","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>The association between different patterns of healthcare use and non-recovery in patients with spinal disorders is unclear. We aimed to assess the association between healthcare use and non-recovery 6 months after a specialist evaluation in Norwegian secondary care and whether non-recovery was linked to adherence to specialist-recommended care.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>This observational registry-based cohort study includes 3745 patients aged 18–70 years (mean (SD) 46 (12) years, 59% women) from the Norwegian Neck and Back Registry (NNRR). We studied non-recovery 6 months after the specialist evaluation using the Global Perceived Effect (GPE) scale, defined as ‘slightly improved’, ‘unchanged’, ‘slightly worse’, ‘much worse’, or ‘worse than ever’. Using logistic regression, we examined the association between non-recovery and specialist-recommended healthcare (i.e., recommended follow-up in primary or secondary care) and actual healthcare use identified in national registries (visits to general practitioners, physical therapists, and chiropractors in primary care and outpatient and inpatient visits in secondary care).</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>In total, 80% self-reported non-recovery at 6 months. Adherence to specialist-recommended healthcare was not associated with non-recovery (adjusted OR [aOR] 1.09, 95% CI 0.91–1.29). Highest odds for non-recovery were among patients using primary care alone (aOR 1.68, 95% CI 1.37–2.07) or no healthcare (aOR 1.81, 95% CI 1.44–2.27). Secondary care alone (aOR 0.75, 95% CI 0.59–0.96) or combined with primary care (aOR 0.49, 95% CI 0.41–0.59) was associated with recovery.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Our findings raise questions about the value of the specialist recommendations and also the content of healthcare services provided after a specialist evaluation.</p>\n </section>\n \n <section>\n \n <h3> Significance Statement</h3>\n \n <p>Our findings suggest that follow-up after specialist evaluation may not adequately meet patient needs, indicating a need for improved management of spinal disorders. Given the low proportion of patients reporting recovery at 6-month follow-up, we highlight the importance of good transitions, care coordination, and coherent messages across sectors and professions. More effective healthcare and reduced sick leave could save societal costs. Moreover, this approach could improve quality of life, enabling a more active and participatory lifestyle.</p>\n </section>\n </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 8","pages":""},"PeriodicalIF":3.4000,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Healthcare Use and Non-Recovery in Patients With Spinal Disorders\",\"authors\":\"Lise Grethe Kjønø, Marianne Bakke Johnsen, Margreth Grotle, Jan Hartvigsen, Stine Clausen, Maja Wilhelmsen, Kåre Rønn Richardsen, Kjersti Storheim, Karin Magnusson\",\"doi\":\"10.1002/ejp.70074\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>The association between different patterns of healthcare use and non-recovery in patients with spinal disorders is unclear. We aimed to assess the association between healthcare use and non-recovery 6 months after a specialist evaluation in Norwegian secondary care and whether non-recovery was linked to adherence to specialist-recommended care.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>This observational registry-based cohort study includes 3745 patients aged 18–70 years (mean (SD) 46 (12) years, 59% women) from the Norwegian Neck and Back Registry (NNRR). We studied non-recovery 6 months after the specialist evaluation using the Global Perceived Effect (GPE) scale, defined as ‘slightly improved’, ‘unchanged’, ‘slightly worse’, ‘much worse’, or ‘worse than ever’. Using logistic regression, we examined the association between non-recovery and specialist-recommended healthcare (i.e., recommended follow-up in primary or secondary care) and actual healthcare use identified in national registries (visits to general practitioners, physical therapists, and chiropractors in primary care and outpatient and inpatient visits in secondary care).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>In total, 80% self-reported non-recovery at 6 months. Adherence to specialist-recommended healthcare was not associated with non-recovery (adjusted OR [aOR] 1.09, 95% CI 0.91–1.29). Highest odds for non-recovery were among patients using primary care alone (aOR 1.68, 95% CI 1.37–2.07) or no healthcare (aOR 1.81, 95% CI 1.44–2.27). Secondary care alone (aOR 0.75, 95% CI 0.59–0.96) or combined with primary care (aOR 0.49, 95% CI 0.41–0.59) was associated with recovery.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>Our findings raise questions about the value of the specialist recommendations and also the content of healthcare services provided after a specialist evaluation.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Significance Statement</h3>\\n \\n <p>Our findings suggest that follow-up after specialist evaluation may not adequately meet patient needs, indicating a need for improved management of spinal disorders. Given the low proportion of patients reporting recovery at 6-month follow-up, we highlight the importance of good transitions, care coordination, and coherent messages across sectors and professions. More effective healthcare and reduced sick leave could save societal costs. Moreover, this approach could improve quality of life, enabling a more active and participatory lifestyle.</p>\\n </section>\\n </div>\",\"PeriodicalId\":12021,\"journal\":{\"name\":\"European Journal of Pain\",\"volume\":\"29 8\",\"pages\":\"\"},\"PeriodicalIF\":3.4000,\"publicationDate\":\"2025-07-28\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"European Journal of Pain\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1002/ejp.70074\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ANESTHESIOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Pain","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/ejp.70074","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ANESTHESIOLOGY","Score":null,"Total":0}

引用次数: 0

摘要

背景：不同的医疗保健使用模式与脊柱疾病患者不康复之间的关系尚不清楚。我们的目的是评估在挪威二级医疗机构进行专家评估后6个月的医疗保健使用与不康复之间的关系，以及不康复是否与依从专家推荐的护理有关。方法：本观察性登记队列研究包括来自挪威颈部和背部登记处（NNRR）的3745例患者，年龄18-70岁（平均（SD） 46（12）岁，59%为女性）。我们使用全球感知效应（GPE）量表进行专家评估后6个月的非恢复研究，定义为“略有改善”，“不变”，“稍差”，“更差”或“比以往更差”。使用逻辑回归，我们检查了未恢复和专家推荐的医疗保健（即，初级或二级医疗的推荐随访）与国家登记中确定的实际医疗保健使用之间的关联（在初级保健中访问全科医生、物理治疗师和脊椎按摩师，在二级保健中访问门诊和住院患者）。结果在6个月时，80%的患者自我报告未恢复。遵医嘱与不康复无关（调整比值比[aOR] 1.09, 95% CI 0.91-1.29）。单独接受初级保健的患者（aOR 1.68, 95% CI 1.37-2.07）或未接受保健的患者（aOR 1.81, 95% CI 1.44-2.27）无法康复的几率最高。单独二级护理（aOR 0.75, 95% CI 0.59-0.96）或联合初级护理（aOR 0.49, 95% CI 0.41-0.59）与康复相关。结论我们的研究结果对专科医生推荐的价值以及专科医生评估后提供的医疗服务内容提出了质疑。我们的研究结果表明，专家评估后的随访可能不能充分满足患者的需求，这表明需要改进脊柱疾病的管理。鉴于在6个月随访时报告康复的患者比例较低，我们强调了良好过渡、护理协调以及跨部门和专业的连贯信息的重要性。更有效的医疗保健和减少病假可以节省社会成本。此外，这种方法可以提高生活质量，实现更积极和参与性的生活方式。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Healthcare Use and Non-Recovery in Patients With Spinal Disorders

Background

The association between different patterns of healthcare use and non-recovery in patients with spinal disorders is unclear. We aimed to assess the association between healthcare use and non-recovery 6 months after a specialist evaluation in Norwegian secondary care and whether non-recovery was linked to adherence to specialist-recommended care.

Methods

This observational registry-based cohort study includes 3745 patients aged 18–70 years (mean (SD) 46 (12) years, 59% women) from the Norwegian Neck and Back Registry (NNRR). We studied non-recovery 6 months after the specialist evaluation using the Global Perceived Effect (GPE) scale, defined as ‘slightly improved’, ‘unchanged’, ‘slightly worse’, ‘much worse’, or ‘worse than ever’. Using logistic regression, we examined the association between non-recovery and specialist-recommended healthcare (i.e., recommended follow-up in primary or secondary care) and actual healthcare use identified in national registries (visits to general practitioners, physical therapists, and chiropractors in primary care and outpatient and inpatient visits in secondary care).

Results

In total, 80% self-reported non-recovery at 6 months. Adherence to specialist-recommended healthcare was not associated with non-recovery (adjusted OR [aOR] 1.09, 95% CI 0.91–1.29). Highest odds for non-recovery were among patients using primary care alone (aOR 1.68, 95% CI 1.37–2.07) or no healthcare (aOR 1.81, 95% CI 1.44–2.27). Secondary care alone (aOR 0.75, 95% CI 0.59–0.96) or combined with primary care (aOR 0.49, 95% CI 0.41–0.59) was associated with recovery.

Conclusions

Our findings raise questions about the value of the specialist recommendations and also the content of healthcare services provided after a specialist evaluation.

Significance Statement

Our findings suggest that follow-up after specialist evaluation may not adequately meet patient needs, indicating a need for improved management of spinal disorders. Given the low proportion of patients reporting recovery at 6-month follow-up, we highlight the importance of good transitions, care coordination, and coherent messages across sectors and professions. More effective healthcare and reduced sick leave could save societal costs. Moreover, this approach could improve quality of life, enabling a more active and participatory lifestyle.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

European Journal of Pain 医学-临床神经学

CiteScore

7.50

自引率

5.60%

发文量

163

审稿时长

4-8 weeks

期刊介绍： European Journal of Pain (EJP) publishes clinical and basic science research papers relevant to all aspects of pain and its management, including specialties such as anaesthesia, dentistry, neurology and neurosurgery, orthopaedics, palliative care, pharmacology, physiology, psychiatry, psychology and rehabilitation; socio-economic aspects of pain are also covered. Regular sections in the journal are as follows: • Editorials and Commentaries • Position Papers and Guidelines • Reviews • Original Articles • Letters • Bookshelf The journal particularly welcomes clinical trials, which are published on an occasional basis. Research articles are published under the following subject headings: • Neurobiology • Neurology • Experimental Pharmacology • Clinical Pharmacology • Psychology • Behavioural Therapy • Epidemiology • Cancer Pain • Acute Pain • Clinical Trials.