BACKGROUND: Management of musculoskeletal conditions in the UK is increasingly delivered in multidisciplinary clinical assessment and treatment services (CATS) at the primary-secondary care interface. However, there is little evidence concerning the characteristics and management of patients attending CATS. AIM: To describe the characteristics, investigation, and treatment of adults attending a musculoskeletal CATS. DESIGN AND SETTING: Cross-sectional analysis of cohort study baseline data from a musculoskeletal CATS in Stoke-on-Trent Primary Care Trust, UK. METHOD: All patients referred from primary care between February 2008 and June 2009 were mailed a pre-consultation questionnaire concerning pain duration, general health status, anxiety, depression, employment status, and work absence due to musculoskeletal problems. At the consultation, clinical diagnoses, body region(s) affected, investigations, and treatment were recorded. RESULT: A total of 2166 (73%) completed questionnaires were received. Chronic pain duration >1 year (55%), major physical limitation (76%), anxiety (49%), and depression (37%) were common. Of those currently employed, 516 (45%) had taken time off work in the last 6 months because of their musculoskeletal problem; 325 (29%) were unable to do their usual job. The most frequent investigations were X-rays (23%), magnetic resonance imaging (18%), and blood tests (14%): 1012 (48%) received no investigations. Injections were performed in 282 (13%) and 492 (23%) were referred to physiotherapy. CONCLUSION: Although most patients presented with musculoskeletal problems suitable for CATS, chronic pain, physical limitation, anxiety, depression, and work disability were commonplace, highlighting the need for a biopsychosocial model of care that addresses psychological, social, and work-related needs, as well as pain and physical disability.
BACKGROUND: Management of musculoskeletal conditions in the UK is increasingly delivered in multidisciplinary clinical assessment and treatment services (CATS) at the primary-secondary care interface. However, there is little evidence concerning the characteristics and management of patients attending CATS. AIM: To describe the characteristics, investigation, and treatment of adults attending a musculoskeletal CATS. DESIGN AND SETTING: Cross-sectional analysis of cohort study baseline data from a musculoskeletal CATS in Stoke-on-Trent Primary Care Trust, UK. METHOD: All patients referred from primary care between February 2008 and June 2009 were mailed a pre-consultation questionnaire concerning pain duration, general health status, anxiety, depression, employment status, and work absence due to musculoskeletal problems. At the consultation, clinical diagnoses, body region(s) affected, investigations, and treatment were recorded. RESULT: A total of 2166 (73%) completed questionnaires were received. Chronic pain duration >1 year (55%), major physical limitation (76%), anxiety (49%), and depression (37%) were common. Of those currently employed, 516 (45%) had taken time off work in the last 6 months because of their musculoskeletal problem; 325 (29%) were unable to do their usual job. The most frequent investigations were X-rays (23%), magnetic resonance imaging (18%), and blood tests (14%): 1012 (48%) received no investigations. Injections were performed in 282 (13%) and 492 (23%) were referred to physiotherapy. CONCLUSION: Although most patients presented with musculoskeletal problems suitable for CATS, chronic pain, physical limitation, anxiety, depression, and work disability were commonplace, highlighting the need for a biopsychosocial model of care that addresses psychological, social, and work-related needs, as well as pain and physical disability.
Authors: Edward Roddy; Irena Zwierska; Peter Dawes; Samantha L Hider; Kelvin P Jordan; Jon Packham; Kay Stevenson; Elaine Hay Journal: BMC Musculoskelet Disord Date: 2010-04-08 Impact factor: 2.362
Authors: Samantha L Hider; Wajeeha Tanveer; Ann Brownfield; Derek L Mattey; Jon C Packham Journal: Rheumatology (Oxford) Date: 2009-07-16 Impact factor: 7.580
Authors: Emma L Healey; Kirstie L Haywood; Kelvin P Jordan; Andrew M Garratt; Sarah Ryan; Jon C Packham Journal: Rheumatology (Oxford) Date: 2009-06-17 Impact factor: 7.580
Authors: Kelvin P Jordan; Umesh T Kadam; Richard Hayward; Mark Porcheret; Catherine Young; Peter Croft Journal: BMC Musculoskelet Disord Date: 2010-07-02 Impact factor: 2.362
Authors: Edward Roddy; Kelvin P Jordan; Raymond Oppong; Ying Chen; Sue Jowett; Peter Dawes; Samantha L Hider; Jon Packham; Kay Stevenson; Irena Zwierska; Elaine M Hay Journal: BMJ Open Date: 2016-10-12 Impact factor: 2.692
Authors: Edward Roddy; Irena Zwierska; Elaine M Hay; Sue Jowett; Martyn Lewis; Kay Stevenson; Danielle van der Windt; Nadine E Foster Journal: BMC Musculoskelet Disord Date: 2014-03-14 Impact factor: 2.362
Authors: Deirdre A Hurley; Amanda M Hall; Laura Currie-Murphy; Tamar Pincus; Steve Kamper; Chris Maher; Suzanne M McDonough; Chris Lonsdale; Nicola E Walsh; Suzanne Guerin; Ricardo Segurado; James Matthews Journal: BMJ Open Date: 2016-01-21 Impact factor: 2.692
Authors: Majid Artus; Danielle A van der Windt; Ebenezer K Afolabi; Rachelle Buchbinder; Linda S Chesterton; Alison Hall; Edward Roddy; Nadine E Foster Journal: BMJ Open Date: 2017-06-21 Impact factor: 2.692