Patients with shoulder syndromes in general and physiotherapy practice: An observational study

M.J.J. Kooijman, I.C.S. Swinkels, C. van Dijk, D.H. de Bakker, C. Veenhof

Research output: Contribution to journalArticleScientificpeer-review

47 Downloads (Pure)

Abstract

Background
Shoulder complaints are commonly seen in general practice and physiotherapy practice. The only complaints for which general practitioners (GPs) refer more patients to the physiotherapist are back and neck pain. However, a substantial group have persistent symptoms. The first goal of this study is to document current health care use and the treatment process for patients with shoulder syndromes in both general practice and physiotherapy practice. The second goal is to detect whether there are differences between patients with shoulder syndromes who are treated by their GP, those who are treated by both GP and physiotherapist and those who access physiotherapy directly.
Methods
Observational study using data from the Netherlands Information Network of General Practice and the National Information Service for Allied Health Care. These registration networks collect healthcare-related information on patient contacts including diagnoses, prescriptions, referrals, treatment and evaluation on an ongoing basis.
Results
Many patients develop symptoms gradually and 35% of patients with shoulder syndromes waited more than three months before visiting a physiotherapist. In 64% of all patients, treatment goals are fully reached at the end of physiotherapy treatment. In general practice, around one third of the patients return after the referral for physiotherapy. Patients with shoulder syndromes who are referred for physiotherapy have more consultations with their GP and are prescribed less medication than patients without a referral. Often, this referral is made at the first consultation. In physiotherapy practice, referred patients differ from self-referrals. Self-referrals are younger, they more often have recurrent complaints and their complaints are more often related to sports and leisure activities.
Conclusions
There is a fairly large group of patients with persistent symptoms. Early referral by a GP is not advised under current guidelines. However, in many patients, symptoms develop gradually and a wait-and-see policy means more valuable time may pass before physiotherapy intervention takes place. Meanwhile a long duration of complaints is a predictor for poor outcome. Therefore, future research into early referral is required. As physiotherapists, we should develop a way of educating patients to avoid lengthy waiting periods before seeking help. To prevent high costs, physiotherapists could consider a classification of pain and limitations and wait-and-see policy as used by GPs. With early detection, a once-off consultation might be sufficient.
Keywords: Shoulder impingement syndrome, Physical therapy specialty, Primary health care
Original languageEnglish
Article number128
JournalBMC Musculoskeletal Disorders
Volume14
DOIs
Publication statusPublished - 2013

Fingerprint

General Practice
Physical Therapists
General Practitioners
Information Services
Physical Therapy Specialty
Delivery of Health Care
Shoulder Impingement Syndrome
Neck Pain
Leisure Activities
Netherlands

Cite this

Kooijman, M. J. J., Swinkels, I. C. S., van Dijk, C., de Bakker, D. H., & Veenhof, C. (2013). Patients with shoulder syndromes in general and physiotherapy practice: An observational study. BMC Musculoskeletal Disorders, 14, [128]. https://doi.org/10.1186/1471-2474-14-128
Kooijman, M.J.J. ; Swinkels, I.C.S. ; van Dijk, C. ; de Bakker, D.H. ; Veenhof, C. / Patients with shoulder syndromes in general and physiotherapy practice : An observational study. In: BMC Musculoskeletal Disorders. 2013 ; Vol. 14.
@article{981ef33b892f4a0081f7e2f3ecd58910,
title = "Patients with shoulder syndromes in general and physiotherapy practice: An observational study",
abstract = "BackgroundShoulder complaints are commonly seen in general practice and physiotherapy practice. The only complaints for which general practitioners (GPs) refer more patients to the physiotherapist are back and neck pain. However, a substantial group have persistent symptoms. The first goal of this study is to document current health care use and the treatment process for patients with shoulder syndromes in both general practice and physiotherapy practice. The second goal is to detect whether there are differences between patients with shoulder syndromes who are treated by their GP, those who are treated by both GP and physiotherapist and those who access physiotherapy directly.MethodsObservational study using data from the Netherlands Information Network of General Practice and the National Information Service for Allied Health Care. These registration networks collect healthcare-related information on patient contacts including diagnoses, prescriptions, referrals, treatment and evaluation on an ongoing basis.ResultsMany patients develop symptoms gradually and 35{\%} of patients with shoulder syndromes waited more than three months before visiting a physiotherapist. In 64{\%} of all patients, treatment goals are fully reached at the end of physiotherapy treatment. In general practice, around one third of the patients return after the referral for physiotherapy. Patients with shoulder syndromes who are referred for physiotherapy have more consultations with their GP and are prescribed less medication than patients without a referral. Often, this referral is made at the first consultation. In physiotherapy practice, referred patients differ from self-referrals. Self-referrals are younger, they more often have recurrent complaints and their complaints are more often related to sports and leisure activities.ConclusionsThere is a fairly large group of patients with persistent symptoms. Early referral by a GP is not advised under current guidelines. However, in many patients, symptoms develop gradually and a wait-and-see policy means more valuable time may pass before physiotherapy intervention takes place. Meanwhile a long duration of complaints is a predictor for poor outcome. Therefore, future research into early referral is required. As physiotherapists, we should develop a way of educating patients to avoid lengthy waiting periods before seeking help. To prevent high costs, physiotherapists could consider a classification of pain and limitations and wait-and-see policy as used by GPs. With early detection, a once-off consultation might be sufficient.Keywords: Shoulder impingement syndrome, Physical therapy specialty, Primary health care",
author = "M.J.J. Kooijman and I.C.S. Swinkels and {van Dijk}, C. and {de Bakker}, D.H. and C. Veenhof",
note = ">2000 woorden",
year = "2013",
doi = "10.1186/1471-2474-14-128",
language = "English",
volume = "14",
journal = "BMC Musculoskeletal Disorders",
issn = "1471-2474",
publisher = "BioMed Central",

}

Patients with shoulder syndromes in general and physiotherapy practice : An observational study. / Kooijman, M.J.J.; Swinkels, I.C.S.; van Dijk, C.; de Bakker, D.H.; Veenhof, C.

In: BMC Musculoskeletal Disorders, Vol. 14, 128, 2013.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Patients with shoulder syndromes in general and physiotherapy practice

T2 - An observational study

AU - Kooijman, M.J.J.

AU - Swinkels, I.C.S.

AU - van Dijk, C.

AU - de Bakker, D.H.

AU - Veenhof, C.

N1 - >2000 woorden

PY - 2013

Y1 - 2013

N2 - BackgroundShoulder complaints are commonly seen in general practice and physiotherapy practice. The only complaints for which general practitioners (GPs) refer more patients to the physiotherapist are back and neck pain. However, a substantial group have persistent symptoms. The first goal of this study is to document current health care use and the treatment process for patients with shoulder syndromes in both general practice and physiotherapy practice. The second goal is to detect whether there are differences between patients with shoulder syndromes who are treated by their GP, those who are treated by both GP and physiotherapist and those who access physiotherapy directly.MethodsObservational study using data from the Netherlands Information Network of General Practice and the National Information Service for Allied Health Care. These registration networks collect healthcare-related information on patient contacts including diagnoses, prescriptions, referrals, treatment and evaluation on an ongoing basis.ResultsMany patients develop symptoms gradually and 35% of patients with shoulder syndromes waited more than three months before visiting a physiotherapist. In 64% of all patients, treatment goals are fully reached at the end of physiotherapy treatment. In general practice, around one third of the patients return after the referral for physiotherapy. Patients with shoulder syndromes who are referred for physiotherapy have more consultations with their GP and are prescribed less medication than patients without a referral. Often, this referral is made at the first consultation. In physiotherapy practice, referred patients differ from self-referrals. Self-referrals are younger, they more often have recurrent complaints and their complaints are more often related to sports and leisure activities.ConclusionsThere is a fairly large group of patients with persistent symptoms. Early referral by a GP is not advised under current guidelines. However, in many patients, symptoms develop gradually and a wait-and-see policy means more valuable time may pass before physiotherapy intervention takes place. Meanwhile a long duration of complaints is a predictor for poor outcome. Therefore, future research into early referral is required. As physiotherapists, we should develop a way of educating patients to avoid lengthy waiting periods before seeking help. To prevent high costs, physiotherapists could consider a classification of pain and limitations and wait-and-see policy as used by GPs. With early detection, a once-off consultation might be sufficient.Keywords: Shoulder impingement syndrome, Physical therapy specialty, Primary health care

AB - BackgroundShoulder complaints are commonly seen in general practice and physiotherapy practice. The only complaints for which general practitioners (GPs) refer more patients to the physiotherapist are back and neck pain. However, a substantial group have persistent symptoms. The first goal of this study is to document current health care use and the treatment process for patients with shoulder syndromes in both general practice and physiotherapy practice. The second goal is to detect whether there are differences between patients with shoulder syndromes who are treated by their GP, those who are treated by both GP and physiotherapist and those who access physiotherapy directly.MethodsObservational study using data from the Netherlands Information Network of General Practice and the National Information Service for Allied Health Care. These registration networks collect healthcare-related information on patient contacts including diagnoses, prescriptions, referrals, treatment and evaluation on an ongoing basis.ResultsMany patients develop symptoms gradually and 35% of patients with shoulder syndromes waited more than three months before visiting a physiotherapist. In 64% of all patients, treatment goals are fully reached at the end of physiotherapy treatment. In general practice, around one third of the patients return after the referral for physiotherapy. Patients with shoulder syndromes who are referred for physiotherapy have more consultations with their GP and are prescribed less medication than patients without a referral. Often, this referral is made at the first consultation. In physiotherapy practice, referred patients differ from self-referrals. Self-referrals are younger, they more often have recurrent complaints and their complaints are more often related to sports and leisure activities.ConclusionsThere is a fairly large group of patients with persistent symptoms. Early referral by a GP is not advised under current guidelines. However, in many patients, symptoms develop gradually and a wait-and-see policy means more valuable time may pass before physiotherapy intervention takes place. Meanwhile a long duration of complaints is a predictor for poor outcome. Therefore, future research into early referral is required. As physiotherapists, we should develop a way of educating patients to avoid lengthy waiting periods before seeking help. To prevent high costs, physiotherapists could consider a classification of pain and limitations and wait-and-see policy as used by GPs. With early detection, a once-off consultation might be sufficient.Keywords: Shoulder impingement syndrome, Physical therapy specialty, Primary health care

U2 - 10.1186/1471-2474-14-128

DO - 10.1186/1471-2474-14-128

M3 - Article

VL - 14

JO - BMC Musculoskeletal Disorders

JF - BMC Musculoskeletal Disorders

SN - 1471-2474

M1 - 128

ER -