The course and prognosis of hip complaints in general practice

• Published in: Annals of behavioral medicine 2006-06, Vol.31 (3), p.297-308
• Main Authors: van der Waal, Johanna M, Bot, Sandra D M, Terwee, Caroline B, van der Windt, Danielle A W M, Bouter, Lex M, Dekker, Joost
• Format: Article
• Language: English
• Subjects: Adaptation, Psychological; Cohort Studies; Disease Progression; Female; Health psychology; Health Status; Hip Injuries - epidemiology; Hip Injuries - physiopathology; Humans; Male; Middle Aged; Pain; Pain - epidemiology; Primary care; Primary Health Care; Prognosis; Prospective Studies; Studies; Surveys and Questionnaires
• ISSN: 0883-6612; 1532-4796
• DOI: 10.1207/s15324796abm3103_12

The general practitioner needs to discriminate complaints with need of specialist care from those that can be managed in primary care. However, no previous research has studied prognostic indicators for the course of hip complaints in a primary care population. The purpose of this study was to investigate the course of hip complaints presented in general practice and to identify relevant prognostic indicators of outcome. Data were collected by means of self-administered questionnaires containing questions about sociodemographic variables, characteristics of the complaints, and several intraindividual and extraindividual factors, including several psychosocial variables (e.g., pain coping, distress, and kinesiophobia). After 3 and 12 months of follow-up perceived recovery, change in pain intensity and change in functioning were assessed. Multiple regression analyses were performed to investigate the association between the potential prognostic indicators and the 3 outcome measures. We included 139 patients with hip complaints, presented in general practice. Only 24% reported recovery after 3 months, increasing to 37% after 12 months. A history of hip complaints, a longer duration of the current episode of hip complaints, or more severe complaints, were associated with a less favorable prognosis. Furthermore, more vital patients and patients who met the Norm for Healthy Activity had a higher probability of a favorable outcome. Pain transformation and worrying were significant associated with recovery and changes in functioning after 3 months. Different prognostic indicators were found to be associated with perceived recovery, changes in pain intensity, and changes in functioning. Future research should aim at investigating the mechanisms that can underlie these associations.