Matching treatment options for risk sub-groups in musculoskeletal pain: A consensus groups study
BMC Musculoskeletal Disorders Jun 07, 2019
Protheroe J, et al. - Researchers conducted three consensus group meetings with multi-disciplinary groups of practitioners (n = 20) who work with musculoskeletal (MSK) pain represents a considerable worldwide healthcare burden. This study aimpain patients using Nominal Group Technique in order to gain consensus on the most appropriate primary care treatment options for subgroups of patients based on prognostic risk of persistent disabling pain. They sought agreement on treatment options for the five most common MSK pain presentations (back, neck, knee, shoulder and multisite pain), across three risk subgroups (low, medium and high). “Education and advice” and “simple oral and topical pain medications” were agreed to be appropriate for all five pain presentations for all subgroups. “Review by primary care practitioner if not improving after 6 weeks” reached consensus for patients at low risk across all five pain presentations. For those at medium risk, slight differences in treatment options was noted across pain-presentations, however, these all included: “consider referral to physiotherapy” and “consider referral to MSK-interface-clinic”. For patients at high risk, they also noted variation in treatment options by pain presentation. Some of the options for these patients were same as those for patients at medium risk; additional options comprised: “opioids”; “consider referral to expert patient programme” (across all pain presentations); and “consider referral for surgical opinion” (back, knee, neck, shoulder). For patients at medium and high risk who have multisite pain, agreement for “consider referral to rheumatology” was noted.
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