Table.
Availability of recommended back pain services reported by general practices in initial study (1994-5) and in follow up study (1996-7). Values are proportions (percentages) of practices giving valid responses to each question unless stated otherwise
| Recommended service | Initial study, 1994-5 | Follow up study, 1996-7
|
% difference (95% CI)
|
|||
|---|---|---|---|---|---|---|
| Study panel | Second sample | Between study panel 1996-7 and panel 1994-5* | Between study panel and second sample, 1996-7† | |||
| For patients with suspected cauda equina compression or widespread neurological disorder there is a locally agreed person for emergency referral who would assess the patient within hours | 116/186 (62) | 113/186 (61) | 98/163 (60) | −2 (−9 to 6) | 1 (−10 to 11)‡ | |
| Patients with possibly serious spinal pathology are seen by a consultant within two weeks of referral (may entail telephone call to consultant) | 215/234 (92) | 215/234 (92) | 166/189 (88) | 0 (−4 to 4) | 4 (−2 to 10) | |
| Patients with possible nerve root problems (sciatica) not resolving after six weeks are seen by a consultant within two weeks of referral | 73/225 (32) | 93/225 (41) | 62/187 (33) | 9 (2 to 16)§ | 8 (−1 to 18)‡ | |
| After urgent telephone referral to a physical therapist for simple pain, patients are seen within 72 hours | 103/212 (49) | 115/212 (54) | 92/173 (53) | 6 (−2 to 13) | 1 (−9 to 11)‡ | |
| After routine referral to a physical therapist for simple acute back pain, patients are seen within two weeks | 107/236 (45) | 111/236 (47) | 89/192 (46) | 2 (−6 to 9) | 1 (−9 to 10)‡ | |
| Acute pain relief service is available within 48 hours of telephone request for patients with severe acute pain and distress not responding to standard treatment | 66/221 (30) | 82/221 (37) | 51/176 (29) | 7 (0 to 14)§ | 8 (−1 to 17)‡ | |
| Patients with simple acute pain are seen by a physical therapist before they have been off work for six weeks | 203/247 (82) | 211/247 (85) | 162/194 (84) | 3 (−2 to 8) | 1 (−5 to 9) | |
| Patients with chronic pain after failed primary care management are seen and assessed by a multidisciplinary team before they have been off work for six months | 69/225 (31) | 104/225 (46) | 88/184 (48) | 16 (8 to 23)¶ | −2 (−11 to 8) | |
Values have been rounded (exact confidence interval for routine referral for physical therapy is −8.8 to 10.2).
Physical therapist=physiotherapist, osteopath, or chiropractor.
*
Confidence interval for paired proportions from McNemar’s test.
†
Normal approximation to binomial data.
‡
Services for which reported availability was not shown to be equivalent.
§
P<0.05, ¶P<0.01.