The current use of Patient-Reported Outcome Measures to measure pain and factors associated with pain scores in patients with non-specific neck pain

Abstract

Background: Patient-Reported Outcome Measures (PROMs) to measure pain are highly recommended and may improve quality of health care physiotherapy. Although, little is known about PROMs use in primary care physiotherapy to measure pain, and if the use leads to differences in number of treatment sessions in non-specific neck pain patients. Besides, understanding what determines the pain score may help physiotherapists to make better management decisions in affecting non-specific neck pain. Aim: This study assessed 1) the current use of PROMs to measure pain in Dutch primary healthcare physiotherapy, 2) differences in number of treatment sessions between PROM and non-PROM evaluated patients, and 3) patient- and physiotherapist-related variables associated with pain scores in non-specific neck pain patients. Methods An observational study was conducted, based on electronic health record data in the Nivel Primary Care Database of the year 2018. A total of 1,412 patients aged 18 years or older diagnosed with non-specific neck pain and treated by a primary care physiotherapist were included. Descriptive statistics and Mann-Whitney-U tests were used to explore the current use of PROMs and differences in the number of treatment sessions between PROM evaluated and non-PROM evaluated patients. A backward multiple regression analysis was used to identify associated factors with the change in pain score. Results: Twenty-seven percent of the included patients were evaluated by using PROMs to measure pain. Three hundred eighty-six PROM evaluated patients (mean age 49±17) and 1,026 non-PROM evaluated patients (mean age 49±17) showed that the number of treatment sessions was significantly higher in PROM evaluated patients (7.1±4.5) than non-PROM evaluated patients (6.3±5.0). Multiple regression showed the age of the patient and the number of treatment sessions as associated variables on the change of pain score. Thirty-eight percent of the proportion in variance is explained by our model. Conclusion and key findings: This study showed that the minority of non-specific neck pain patients were evaluated by PROMs in Dutch primary care physiotherapy. PROM evaluated patients showed a higher number of treatment sessions. The age of the patient and the number of treatments were found as associated variables on the change of pain score.