Predictors of sickness absence in patients with a new episode of low back pain in primary care.
This study examines predictors of sickness absence in patients presenting to a health practitioner with acute/ subacute low back pain (LBP). Aims of this study were to identify baseline-variables that detect patients with a new LBP episode at risk of sickness absence and to identify prognostic models for sickness absence at different time points after initial presentation. Prospective cohort study investigating 310 patients presenting to a health practitioner with a new episode of LBP at baseline, three-, six-, twelve-week and six-month follow-up, addressing work-related, psychological and biomedical factors. Multivariate logistic regression analysis was performed to identify baseline-predictors of sickness absence at different time points. Prognostic models comprised 'job control', 'depression' and 'functional limitation' as predictive baseline-factors of sickness absence at three and six-week follow-up with 'job control' being the best single predictor (OR 0.47; 95%CI 0.26-0.87). The six-week model explained 47% of variance of sickness absence at six-week follow-up (p<0.001). The prediction of sickness absence beyond six-weeks is limited, and health practitioners should re-assess patients at six weeks, especially if they have previously been identified as at risk of sickness absence. This would allow timely intervention with measures designed to reduce the likelihood of prolonged sickness absence.
Western Australian Institute for Medical Research, University of Western Australia, Australia.
Markus
M
Melloh
Achim
A
Elfering
Cornelia Rolli
CR
Salathé
Anja
A
Käser
Thomas
T
Barz
Christoph
C
Röder
Jean-Claude
JC
Theis
D000328:Adult; D003863:Depression / Q000523:psychology; D004185:Disability Evaluation; D017050:Episode of Care; D005260:Female; D006801:Humans; D007389:Internal-External Control; D017116:Low Back Pain / Q000175:diagnosis* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care; D011379:Prognosis; D012307:Risk Factors; D018582:Sick Leave; D013997:Time Factors; D055815:Young Adult