Patients’ and clinicians’ perspectives towards primary care consultations for shoulder pain: qualitative findings from the Prognostic and Diagnostic Assessment of the Shoulder (PANDA-S) programme

BMC Musculoskeletal Disorders

Research

T. Pincus¹  C. Burton²  D. A. van der Windt²  G. Wynne-Jones²  B. Saunders²  H. Myers³  R. Chester⁴ 

[1] Faculty of Environmental and Life Sciences (FELS), University of Southampton, Southampton, UK;Primary Care Centre Versus Arthritis, School of Medicine, Keele University, ST5 5BG, Keele, Staffordshire, UK;Primary Care Centre Versus Arthritis, School of Medicine, Keele University, ST5 5BG, Keele, Staffordshire, UK;Clinical Trials Unit, Keele University, Keele, UK;School of Health Sciences, Faculty of Medicine and Health, University of East Anglia, Norwich Research Park, Norwich, UK;

关键词: Shoulder pain;    Primary care;    General practice;    Diagnosis;    Prognosis;    Qualitative;   

DOI  :  10.1186/s12891-022-06059-1

 received in 2022-04-13, accepted in 2022-12-06,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundClinical management of musculoskeletal shoulder pain can be challenging due to diagnostic uncertainty, variable prognosis and limited evidence for long-term treatment benefits. The UK-based PANDA-S programme (Prognostic And Diagnostic Assessment of the Shoulder) is investigating short and long-term shoulder pain outcomes. This paper reports linked qualitative research exploring patients’ and clinicians’ views towards primary care consultations for shoulder pain.MethodsSemi-structured interviews were conducted with 24 patients and 15 primary care clinicians. Twenty-two interviews (11 patients, 11 clinicians) were conducted as matched patient-clinician ‘dyads’. Data were analysed thematically.ResultsClinicians reported attempts to involve patients in management decisions; however, there was variation in whether patients preferred treatment choice, or for decisions to be clinician-led. Some patients felt uncertain about the decisions made, due to a lack of discussion about available management options. Many General Practitioners expressed a lack of confidence in diagnosing the underlying cause of shoulder pain. Patients reported either not being given a diagnosis, or receiving different diagnoses from different professionals, resulting in confusion. Whilst clinicians reported routinely discussing prognosis of shoulder pain, patients reported that prognosis was not raised. Patients also expressed concern that their shoulder pain could be caused by serious pathology; however, clinicians felt that this was not a common concern for patients.ConclusionsFindings showed disparities between patients’ and clinicians’ views towards shoulder pain consultations, indicating a need for improved patient-clinician communication. Findings will inform the design of an intervention to support treatment and referral decisions for shoulder pain that will be tested in a randomised controlled trial.

【 授权许可】

CC BY   
© The Author(s) 2023

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