Gareth Stephens1,2, Seth O'Neill3, Chris Clifford4, Andrew Cuff5, Felipe Forte6, Catrin Hawthorn7, Chris Littlewood2. 1. The Royal Orthopaedic Hospital, Birmingham, UK. 2. Primary Care Centre versus Arthritis, Research Institute for Primary Care and Health Sciences, Keele University, Staffordshire, UK. 3. University of Leicester, Leicester, UK. 4. Gartnavel General Hospital, Glasgow, UK. 5. Wakefield Musculoskeletal Service, Trinity Medical Centre, Wakefield, UK. 6. Sandwell and West Birmingham NHS Hospitals, West Bromwich, UK. 7. Glangwili Hospital, Carmarthen, UK.
Abstract
PURPOSE: Greater trochanteric pain syndrome (GTPS) is a debilitating condition causing lateral hip pain. A recent randomized controlled trial (LEAP) demonstrated that exercise interventions for GTPS provided superior outcomes, compared with corticosteroid injection and wait-and-see approaches. However, participants were not patients seeking care and therefore may not have represented the typical patient seen within the National Health Service (NHS). The present service evaluation aimed to provide data on the characteristics of patients with GTPS presenting to NHS physiotherapy services, to enable consideration of the applicability of the findings of the LEAP trial to patients seeking care within the NHS. METHODS: Four NHS sites provided anonymized data on patients presenting to their service with a primary complaint of GTPS. RESULTS: The data from 162 patients suggested that the typical patients presenting to the NHS with GTPS are female (73%), overweight (body mass index 28.5) and experiencing a 12-month or longer history of lateral hip pain (56.8%). Patients reported high levels of pain (visual analogue score 6.5), low health-related quality of life (EuroQol five-dimensions - 5-level score 0.6), coexisting medical conditions (79.0%) and high medication use (82.7%). CONCLUSIONS:Patients presenting to the NHS withGTPS appear to have multifactorial issues, with high levels of pain and disability, and are often medicated for multiple coexisting conditions. These characteristics differentiate them from patients recruited to the LEAP trial. Hence, it is unclear whether the findings of the LEAP trial are applicable to patients with GTPS who consult physiotherapy services in the NHS. Further research is warranted to evaluate this.
RCT Entities:
PURPOSE: Greater trochanteric pain syndrome (GTPS) is a debilitating condition causing lateral hip pain. A recent randomized controlled trial (LEAP) demonstrated that exercise interventions for GTPS provided superior outcomes, compared with corticosteroid injection and wait-and-see approaches. However, participants were not patients seeking care and therefore may not have represented the typical patient seen within the National Health Service (NHS). The present service evaluation aimed to provide data on the characteristics of patients with GTPS presenting to NHS physiotherapy services, to enable consideration of the applicability of the findings of the LEAP trial to patients seeking care within the NHS. METHODS: Four NHS sites provided anonymized data on patients presenting to their service with a primary complaint of GTPS. RESULTS: The data from 162 patients suggested that the typical patients presenting to the NHS with GTPS are female (73%), overweight (body mass index 28.5) and experiencing a 12-month or longer history of lateral hip pain (56.8%). Patients reported high levels of pain (visual analogue score 6.5), low health-related quality of life (EuroQol five-dimensions - 5-level score 0.6), coexisting medical conditions (79.0%) and high medication use (82.7%). CONCLUSIONS:Patients presenting to the NHS with GTPS appear to have multifactorial issues, with high levels of pain and disability, and are often medicated for multiple coexisting conditions. These characteristics differentiate them from patients recruited to the LEAP trial. Hence, it is unclear whether the findings of the LEAP trial are applicable to patients with GTPS who consult physiotherapy services in the NHS. Further research is warranted to evaluate this.