title: Factors defining care-seeking in low back pain--a meta-analysis of population based surveys.
abstract: Little is known about factors determining health care-seeking behavior in low back pain. While a number of studies have described general characteristics of health care utilization, only a few have aimed at appropriately assessing determinants of care-seeking in back pain, by comparing seekers and non-seekers. The objective of this systematic review was to identify determinants of health care-seeking in studies with well-defined groups of care-seekers and non-seekers with non-specific low back pain. A search was conducted in Medline, AMED, Cinahl, Web of Science, PsycINFO, National Research Register, Cochrane Library and LILACS looking for population- based surveys of non-specific low back pain patients older than 18 years, published since 1966. To be included in the review, studies needed to report on characteristics of well-defined groups of care-seekers and non-seekers. Methodological quality was assessed using a criteria list based on sampling, response rate, data reproducibility, power calculation and external validity. Risk estimates were expressed as odd ratios (95% confidence intervals). When possible, meta-analyses were performed, using a random effects model. Eleven studies were included in the review. Pooled results show that women are slightly more likely to seek care for their back pain as are patients with a previous history of back pain. Pain intensity was only slightly associated with care-seeking, whereas patients with high levels of disability were nearly eight times more likely to seek care than patients with lower levels of disability.
authors.affiliation: Clinical and Rehabilitation Sciences Research Group, University of Sydney, Australia. mferreira@usyd.edu.au
authors.forename: Manuela L
authors.initials: ML
authors.lastname: Ferreira
authors.forename: Gustavo
authors.initials: G
authors.lastname: Machado
authors.forename: Jane
authors.initials: J
authors.lastname: Latimer
authors.forename: Christopher
authors.initials: C
authors.lastname: Maher
authors.forename: Paulo H
authors.initials: PH
authors.lastname: Ferreira
authors.forename: Rob J
authors.initials: RJ
authors.lastname: Smeets
mesh_terms: D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D005260:Female; D006306:Health Surveys; D006801:Humans; D017116:Low Back Pain / Q000523:psychology / Q000628:therapy*; D008297:Male; D010342:Patient Acceptance of Health Care; D012737:Sex Factors; D014481:United States