title: Is there a gender bias in recommendations for further rehabilitation in primary care of patients with chronic pain after an interdisciplinary team assessment?
abstract: OBJECTIVE
  To examine potential gender bias in recommendations of further examination and rehabilitation in primary care for patients with chronic musculoskeletal pain after an interdisciplinary team assessment.
  
  
  METHODS
  The population consisted of consecutive patients (n = 589 women, 262 men) referred during a 3-year period from primary healthcare for assessment by interdisciplinary teams at a pain specialist rehabilitation clinic. Patient data were collected from the Swedish Quality Registry for Pain Rehabilitation. The outcome was defined as the examination or rehabilitation that was specified in the patient's record.
  
  
  RESULTS
  Men had a significantly higher likelihood than women of being recommended physiotherapy and radiological examination, and the gender difference was not explained by confounding variables and covariates (age, marital status, ethnicity, education, working status, pain severity, pain interference, pain sites, anxiety and depression). There was no significant gender difference in recommendations to treatment by specialist physician, occupational therapist, psychologist or social worker.
  
  
  CONCLUSIONS
  Our findings indicate that the interdisciplinary teams in specialist healthcare may discriminate against women with chronic pain when physiotherapy and radiological investigation are recommended. The team's choice of recommendations might be influenced by gendered attitudes, but this field of research needs to be studied further.
authors.affiliation: Department of Community Medicine and Rehabilitation, Rehabilitation Medicine, Bldg 9A , Umeå University, SE-901 87 Umeå, Sweden. brittmarie.stalnacke@rehabmed.umu.se.
authors.forename: Britt-Marie
authors.initials: BM
authors.lastname: Stålnacke
authors.forename: Inger
authors.initials: I
authors.lastname: Haukenes
authors.forename: Arja
authors.initials: A
authors.lastname: Lehti
authors.forename: Anncristine Fjellman
authors.initials: AF
authors.lastname: Wiklund
authors.forename: Maria
authors.initials: M
authors.lastname: Wiklund
authors.forename: Anne
authors.initials: A
authors.lastname: Hammarström
mesh_terms: D000328:Adult; D000368:Aged; D059350:Chronic Pain / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D059408:Pain Management / Q000639:trends*; D011320:Primary Health Care / Q000379:methods*; D063507:Sexism / Q000706:statistics & numerical data*