Prognostic indicators for non-recovery of non-traumatic complaints at arm, neck and shoulder in general practice--6 months follow-up.
OBJECTIVE
To identify predictors of non-recovery in non-traumatic complaints at the arm, neck and shoulder in general practice 6 months after the first consultation.


METHODS
A prospective cohort study was set in 21 Dutch general practices. Consulters with a first or new episode of non-traumatic arm, neck or shoulder complaints and age 18 through 64 yrs entered the cohort. Complaint, patient, physical, psychosocial and work characteristics were investigated as possible predictors of non-recovery at 6 months using multiple logistic regression analyses (backward Wald).


RESULTS
At 6 months, 46% of the total population (n = 612) and 42% of the working subpopulation (n = 473) still reported complaints. Complaint characteristics (long duration of the complaint before consultation, recurrent complaint, musculoskeletal comorbidity and complaint mainly located at wrist or hand) were most predictive of non-recovery followed by psychosocial characteristics (more somatization and experiencing less social support). Having a specific diagnosis was associated with recovery. In the working subpopulation, the same variables were predictors of non-recovery. Additionally, low supervisory support was associated with non-recovery. The models correctly classified 72-75% of the patients (explained variance 0.27-0.28).


CONCLUSIONS
Besides questions on complaint characteristics, information on somatization and support can help a general practitioner to recognize patients at risk of persistent complaints.
Feleus
A
A
Department of General Practice, Room Ff 320, Erasmus Medical Center Rotterdam, PO Box 1738, 3000 DR Rotterdam, The Netherlands.
Bierma-Zeinstra
S M A
SM
Miedema
H S
HS
Verhagen
A P
AP
Nauta
A P
AP
Burdorf
A
A
Verhaar
J A N
JA
Koes
B W
BW
D000293:Adolescent; D000328:Adult; D004651:Employment; D005194:Family Practice; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000175:diagnosis* / Q000523:psychology / Q000534:rehabilitation; D016272:Occupational Health; D011379:Prognosis; D012307:Risk Factors; D012720:Severity of Illness Index; D012944:Social Support; D013001:Somatoform Disorders / Q000175:diagnosis / Q000534:rehabilitation; D034941:Upper Extremity