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041 Knowledge of Features of Inflammatory Back Pain in Primary Care in West Midlands: A Cross-Sectional Survey
S. Elamanchi, N. Barkham, T. Adizie, A. Prabu, A. Pace, R. Laxminarayan
Background: A cardinal feature of AS is a history of inflammatory back pain (IBP) as defined by the Calin criteria, but little is known about general practitioners (GPs) knowledge or use of these criteria. The diagnosis of AS is often delayed, and t…
Background: A cardinal feature of AS is a history of inflammatory back pain (IBP) as defined by the Calin criteria, but little is known about general practitioners (GPs) knowledge or use of these criteria. The diagnosis of AS is often delayed, and this has prognostic significance since patients with shorter disease duration ( < 10 years) tend to do better with anti-TNF therapy. The objective of this study was to assess the current practice of local GPs in using clinical, radiological and laboratory investigations to assess patients with IBP. Methods: An observational questionnaire–based survey covering 12 West Midlands CCGs. The questionnaire took 10minutes to complete and included GPs’ demographic details, the diagnostic features of mechanical vs IBP and their approach to investigation and referral. GPs were asked to rate the importance of each symptom as an indication of IBP (1–10 scale) and the same symptoms as indicators of mechanical back pain. The mean scores and deltas were compared to identify which symptoms were perceived as discriminatory by GPs. They were asked about their confidence in diagnosing IBP and regarding education. Results: A total of 141 GPs responded. The four most important symptoms (out of 10) for predicting IBP were morning stiffness (mean score 8.8/10), sleep disturbances caused by back pain (7.3), insidious onset (7.1) and age of onset < 45 years (7.1). Early morning stiffness and insidious onset performed well as discriminators for IBP ( (cid:2) of 5.2 and 4.1, respectively), but improvement with exercise did not perform well with a (cid:2) of (cid:2)
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 0 2016