Patients with shoulder complaints in general practice: consumption of medical care

Rheumatology (Oxford). 2011 Feb;50(2):389-95. doi: 10.1093/rheumatology/keq333. Epub 2010 Nov 2.

Abstract

Objective: To describe the medical consumption [general practitioner (GP) consultation, referrals, medication consumption] of patients with shoulder complaints in general practice.

Methods: Data were obtained from a primary-care medical registration network. All patients aged ≥18 years with new shoulder complaints who consulted their general practitioner in 1998 were included, and were followed 10 years beyond the initial consultation.

Results: A total of 526 incident cases were identified (average age 47 years, 65% women and average follow-up 7.6 years). Nearly half of the patients consulted their GP only once. For 79% of those patients, a wait-and-see policy or a prescription for NSAIDs sufficed. During follow-up, 65% of all patients were prescribed medication. Medication consumption was significantly higher among men than women, and higher for the 45- to 64-year age group compared with the younger group. A total of 199 patients were referred, of which 84% was to a physiotherapist and 16% to secondary care. Only two patients had surgery, performed by an orthopaedic surgeon. The GP recorded a diagnosis in only 14% of patients; rotator cuff disorder being the most common.

Conclusions: Nearly half of patients with a new shoulder complaint consult their GP only once. Medical consumption in general practice is highest for male shoulder patients and the 45- to 64-year age group. Shoulder problems are mainly an issue for primary care.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Clinical Competence / standards*
  • Female
  • General Practitioners / standards*
  • Humans
  • Male
  • Middle Aged
  • Netherlands
  • Patient Satisfaction
  • Practice Patterns, Physicians' / economics
  • Practice Patterns, Physicians' / standards*
  • Primary Health Care / economics
  • Referral and Consultation
  • Sex Factors
  • Shoulder Pain / diagnosis
  • Shoulder Pain / psychology*
  • Young Adult