Family Practice Vol. 16, No. 3, 233-237
© Oxford University Press 1999
Attitudes toward management of patients with subacromial pain in Swedish primary care
Department of Medicine and Care, Primary care, Faculty of Health Sciences, 581 85 Linköping and
a Department of Neuroscience and Locomotion, Plastic Surgery, Hand Surgery and Burns, Faculty of Health Sciences, Linköping, Sweden.
Objective. We aimed to describe the attitudes among GPs and physiotherapists toward the diagnostic approach and management of patients with a common shoulder disorder.
Method.A questionnaire was sent out to 188 GPs and 71 physiotherapists. The total response rate was 71.8%. The questions were based on a written case simulation with cues about history and symptoms.
Results. The results showed a unanimous opinion of the diagnosis. Rotator cuff tendinitis was marked as the most probable. The two groups showed similarities in the way that they would examine the patient. The GPs referred the patients to the physiotherapists significantly more often than the other way around. The most probable choice of treatment made by the GPs was non-steroidal anti-inflammatory drugs (NSAIDs) and by the physiotherapists, movement exercises together with ergonomics. Most treatment alternatives had at least 20% of the responders marking a neutral attitude, and few treatments were disregarded.
Conclusions.We conclude that in Swedish primary care GPs and physiotherapists have a uniform diagnostic approach towards patients with subacromial pain, but their choice of treatment reflects an uncertainty about the effectiveness of conservative treatments. The questioned pathogenesis of the suggested diagnosis and lack of research regarding the efficacy of conservative treatments could explain this uncertainty.
Keywords. Conservative treatment, general practice, questionnaire, shoulder problems, written case simulation.
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