Use of General Practitioner Services Among Workers with Work-Related Low Back Pain: A Systematic Review.
Preeti Maharjan, Asmare Gelaw, Daniel Griffiths and 2 others
PMID 38652423WHAT IT FOUND
GP service use for work-related low back pain varies wildly from 11% to 99.3%, driven by how long the study followed patients and which country's compensation rules applied.
This variation means a single prevalence figure is meaningless for planning allied health referrals.
Key findings
01Reported prevalence of GP service use ranged from 11% at five years follow-up to 99.3% during two years after a compensated claim.
02Studies using large administrative workers' compensation datasets reported higher prevalence (70% to 99.3%) than those using small GP clinic records (11% to 39%).
03Only three of the seven included studies reported determinants of GP service use, and none explored workers' compensation policy factors despite their known impact.
STILL TO COME
How it was doneWhat they found
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What it does not show
Only seven studies were eligible, and they covered only Australia, Canada and the United States, so findings do not apply to other compensation systems or regions. Heterogeneity in prevalence periods and data sources means the reported figures are not directly comparable and cannot be pooled into a single estimate. US studies used small GP clinic samples (n=87), which may not represent workers who seek care outside those specific clinics, artificially lowering apparent prevalence. Only one study specified the type of low back pain as acute and uncomplicated, so prevalence could not be analysed by clinical presentation. Data sources ranged from 1987 to 2015, so current compensation policies and GP service use patterns may differ substantially. The review could not determine whether high GP service use reflects clinical need, administrative requirements, or lack of access to allied health alternatives.
Declared interests
Funding was provided by Monash University. No other conflicts of interest were declared in the provided text.
The easy way to misread this
Do not interpret the higher GP service use in Australia and Canada as evidence that workers there have more severe back pain or use more healthcare. The difference is largely an artefact of study design, as those countries' studies used comprehensive administrative datasets while the US studies relied on small samples from specific GP clinics that missed a large portion of the worker population.