[Chronic musculo-skeletal pain in Switzerland: patient care from the view of physicians and patients].
A considerable percentage of the population suffers from chronic musculoskeletal pain (CMP) and patient management does not appear to be optimal. The aim of the present investigations was to assess and evaluate epidemiologic data and discover eventual deficits in patient management. This investigation included several sequential steps: First a European study including Switzerland evaluated the prevalence and characteristics of patients with CMP as well as of the treating physicians. The results were discussed and elaborated in two workshops, where general practitioners and patients were included. In a further step the results of these workshops were evaluated again in a telephone survey addressing patients and physicians both in the French and German speaking parts of Switzerland. Considerable deficits were discovered in the management of patients with CMP: In 35% no firm diagnosis was established, the life quality was considerably reduced in about 13 of the patients, the patients' information on their disorders were found to be rather limited, furthermore, there were misconceptions about medical treatment. The two workshops confirmed the results of the first study. The causes of pain often remained unclear, there were considerable communication problems between patient and physician, medical treatment appeared to be inappropriate, and there were deficits in the time management during consultations. The telephone survey confirmed these deficits. In conclusion management of patients with CMP is characterized by considerable deficits such as missing or unclear diagnosis, misconceptions in medical contexts and treatment. Many of the deficits may be improved and call for measures for optimizing the management of patients with CMP.
Michel
B A
BA
Rheumaklinik und Institut für Physikalische Medizin, Universitätsspital Zürich, Zurich. beat.michel@usz.ch
Tschumi
U
U
Woolf
A D
AD
Zeidler
H
H
Beglinger
Ch
Ch
Dalvit
G
G
Felder
M
M
Graf
A
A
Steurer
J
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects / Q000627:therapeutic use; D001291:Attitude of Health Personnel; D002908:Chronic Disease; D003431:Cross-Cultural Comparison; D003430:Cross-Sectional Studies; D004493:Education; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D010146:Pain / Q000453:epidemiology / Q000209:etiology; D059408:Pain Management; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D010353:Patient Education as Topic; D017060:Patient Satisfaction; D026741:Physical Therapy Modalities; D011788:Quality of Life; D013557:Switzerland; D055815:Young Adult
D000894:Anti-Inflammatory Agents, Non-Steroidal