This lecture was given by Professor Gary Macfarlane, Professor of Epidemiology at the University of Aberdeen, to the North British Pain Association Spring Scientific Meeting in Edinburgh on Friday 18th May, 2007. Professor Macfarlane is introduced by Dr Colin Rae. The lecture forms part of a conference "Blurring the Boundaries - Managing Pain in Primary Care and Secondary Care".
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Can Primary Care Provide Effective Management of Chronic Pain?
1. Can Primary Care Provide Effective Management of Chronic Pain? Gary J Macfarlane Professor of Epidemiology
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3. Lifetime prevalence of back pain Papageorgiou et al, 1995 Population: Manchester, UK (N=7669) South Manchester LBP study 1991-3 0 10 20 30 40 50 60 70 80 18-29 30-44 45-59 60+ Prevalence (%) Lifetime prevalence 1-year prevalence 1-year consultation
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6. Low Back Pain Guidelines National guidelines on primary care management in 12 countries Differences : development groups, target populations, methods used
45. Back Beliefs: Population-level Back Pain Beliefs Questionnaire Intervention 26.1 26.3 26.2 26.3 NSW 28.8 29.7 28.4 26.5 Victoria 3 years later After During Before
46. Informing management: Re-think expectations ? Interventions - individual/populations - target risk factors - patient beliefs Re-examine aetiology of onset and outcome ? Improved measurement of known risk factors ?
47. The STarT Back Screening Study S ub-grouping for Tar geted T reatment in Low Back Pain The STarT Back Team: EM Hay, S Somerville, JC Hill, E Mason, C Vohora, T Whitehurst, G Sowden, K Konstantinou, CJ Main, K Dunn, J Bailey, C Calverley University of Keele
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53. STarT Back Screening Tool Patient with prognostic indicators of persistent LBP A mix of different prognostic indicators Patient without prognostic indicators of persistent LBP Low risk 26% High risk 26% Medium risk 48% High psychosocial prognostic indicators
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55. Informing management: Re-think expectations ? Interventions - individual/populations - target risk factors - patient beliefs Re-examine aetiology of onset and outcome ? Improved measurement of known risk factors ?