Management of Low Back Pain in Ghana: A Survey of Self-reported Practice

Oppong-Yeboah, Bertha; May, Stephen

doi:10.1002/pri.1586

Cited by 22 publications

(20 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…While more than 80% of the Ethiopian population live in rural settings, general and specialised hospitals with relatively better services are concentrated in urban regions of the country. A similar problem was noted in the findings of a study undertaken in Ghana, which indicated that 60% physiotherapists in the country were found in large hospitals in urban areas (Oppong‐Yeboah & May ). Indeed, such issues are not only confined to low‐income countries.…”

Section: Discussionsupporting

confidence: 71%

“…This study showed that injection of medications was the most common treatment received by LBP patients. This may reflect a lack of attention among healthcare providers to existing clinical guidelines (Oppong‐Yeboah & May ). The most current clinical guidelines reflect that there is a clear movement away from medicalised to non‐medicalised management of LBP (Chenot et al, ; Qaseem, Wilt, McLean, & Forciea, ; Stochkendahl et al, ).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Determinants of healthcare utilisation for low back pain: A population‐based study in Ethiopia

Beyera

O’Brien

Campbell

2020

Health Soc Care Community

View full text Add to dashboard Cite

Low back pain (LBP) remains one of the major public health problems worldwide. However, in low‐income countries, such as those in Africa, the epidemiological data on healthcare utilisation for LBP are lacking due to more pressing problems such as infectious diseases, to which the majority of health resources are channelled. Therefore, this study aimed at investigating the determinants of healthcare utilisation for LBP in the general population of Ethiopia. A population‐based cross‐sectional study was conducted in South‐West Shewa zone of Ethiopia from June to November 2018. The data were collected by interviewing adults with LBP (n = 1812, randomly selected) using a psychometrically tested and validated instrument, analysed using R version 3.5.1. A log‐binomial regression model was used to determine the prevalence ratio with a 95% confidence interval (CI) in identifying factors associated with healthcare utilisation for LBP. Estimates of population parameters were also presented with 95% CIs and p values. For all applications of inferential statistics, a p value of ≤.05 was taken as the significance level. The lifetime prevalence of healthcare utilisation for LBP was 36.1%, 95% CI: 33.9–38.1, while the annual prevalence rate was 30%, 95% CI: 27.9–32.2. Of those with a 1‐year history of healthcare utilisation, while 7.4%, 95% CI: 4.9–10.3 rural and 36.6%, 95% CI: 29.5–44 urban populations utilised healthcare from general hospitals, 1.4%, 95% CI: 0.3–2.7 rural and 6.8%, 95% CI: 3.1–10.8 urban populations utilised healthcare from specialised hospitals. Several sociodemographic factors, modifiable health behaviours/lifestyle habits, pain interrelated factors, and specific factors such as beliefs about the pain, depressive symptoms and insomnia were associated with healthcare utilisation for LBP. The implications of this research are that it may be prudent for the Ethiopian healthcare policy makers to develop the necessary strategies to meet the health needs of both urban and rural populations with LBP.

show abstract

Section: Discussionsupporting

confidence: 71%

Section: Discussionmentioning

confidence: 99%

Determinants of healthcare utilisation for low back pain: A population‐based study in Ethiopia

Beyera

O’Brien

Campbell

2020

Health Soc Care Community

View full text Add to dashboard Cite

show abstract

“…After removing duplicates and screening 8567 titles and abstracts and 254 full-texts reports, 94 studies were included (figure 1). Physical therapy treatment choices were investigated for low back pain (n=48 studies),11–58 knee pain (n=10),32 34 57 59–65 neck pain or whiplash (n=11),15 18 32 34 51 66–71 foot or ankle pain (n=5),72–76 shoulder pain (n=7),15 51 77–81 pre or post knee arthroplasty (n=6)46 82–86 (including one study of hip and knee arthroplasty86) and other musculoskeletal or orthopaedic conditions (where treatment choices were only reported in one study or where one of either recommended or not recommended treatments could not be inferred from guidelines or systematic reviews) (n=18) 87–104. We contacted 15 authors for data (regarding 18 studies): 12 responded and 5 were able to provide the data we requested (regarding six studies) 15 16 22 64 89 100.…”

Section: Resultsmentioning

confidence: 99%

Do physical therapists follow evidence-based guidelines when managing musculoskeletal conditions? Systematic review

2019

View full text Add to dashboard Cite

ObjectivesPhysicians often refer patients with musculoskeletal conditions to physical therapy. However, it is unclear to what extent physical therapists’ treatment choices align with the evidence. The aim of this systematic review was to determine what percentage of physical therapy treatment choices for musculoskeletal conditions agree with management recommendations in evidence-based guidelines and systematic reviews.DesignSystematic review.SettingWe performed searches in Medline, Embase, Cumulative Index to Nursing and Allied Health Literature, Cochrane Central Register of Controlled Trials, Allied and Complementary Medicine, Scopus and Web of Science combining terms synonymous with ‘practice patterns’ and ‘physical therapy’ from the earliest record to April 2018.ParticipantsStudies that quantified physical therapy treatment choices for musculoskeletal conditions through surveys of physical therapists, audits of clinical notes and other methods (eg, audits of billing codes, clinical observation) were eligible for inclusion.Primary and secondary outcomesUsing medians and IQRs, we summarised the percentage of physical therapists who chose treatments that were recommended, not recommended and had no recommendation, and summarised the percentage of physical therapy treatments provided for various musculoskeletal conditions within the categories of recommended, not recommended and no recommendation. Results were stratified by condition and how treatment choices were assessed (surveys of physical therapists vs audits of clinical notes).ResultsWe included 94 studies. For musculoskeletal conditions, the median percentage of physical therapists who chose recommended treatments was 54% (n=23 studies; surveys completed by physical therapists) and the median percentage of patients that received recommended physical therapy-delivered treatments was 63% (n=8 studies; audits of clinical notes). For treatments not recommended, these percentages were 43% (n=37; surveys) and 27% (n=20; audits). For treatments with no recommendation, these percentages were 81% (n=37; surveys) and 45% (n=31; audits).ConclusionsMany physical therapists seem not to follow evidence-based guidelines when managing musculoskeletal conditions. There is considerable scope to increase use of recommended treatments and reduce use of treatments that are not recommended.PROSPERO registration numberCRD42018094979.

show abstract

“…A recent study on the management of LBP in Ghana showed that many cases of LBP were addressed with treatments that may not be evidence‐based; for example, 80% of patients received thermoelectric‐based treatments, which are not recommended by most clinical practice guidelines for LBP. The study also highlighted the urban‐rural divide in access to care within Ghana: 60% of physiotherapists in Ghana are located in large hospitals …”

Section: Introductionmentioning

confidence: 99%

“…The study also highlighted the urban-rural divide in access to care within Ghana: 60% of physiotherapists in Ghana are located in large hospitals. 13 This study aims to supplement the limited data available on the prevalence of LBP in rural African populations. It was conducted with the help of Rural Education and Community Health 4 Ghana (R4G), a nonprofit organization based in Richmond, Virginia, that works closely with faculty and students from the Virginia Commonwealth University School of Medicine (VCU SOM) to organize an annual medical mission trip to the rural Volta region of Ghana.…”

Section: Introductionmentioning

confidence: 99%

Prevalence and Characteristics of Low Back Pain in a Rural Ghana Primary Care Clinic Population

Miller

Hasan

Kirk

et al. 2019

PM&R

View full text Add to dashboard Cite

Introduction Low back pain (LBP) is the leading cause of disability in the developed world. Less is known about the impact of LBP in the developing world, and particularly the rural developing world. In 2015, the World Health Organization (WHO) issued an urgent call for additional research into the prevalence and effect of LBP on developing world populations. Objective To calculate the prevalence of LBP in a rural Ghana primary care clinic population. Design Survey of LBP prevalence and severity. Setting Primary care mission clinic in rural Southeastern Ghana. Participants Six hundred eighty‐four adult patients. Methods All adult patients were screened for LBP using the definition “any pain occurring within the region between the lower margin of the 12th ribs and the gluteal folds.” The Oswestry Disability Index (ODI) was used to further characterize LBP in those screening positive. Chi‐square test was used to assess statistical significance of difference in prevalence between groups, and ordinary least squares regression was used to assess the relationship between LBP severity and gender and age. Main Outcome Measurements LBP prevalence and LBP severity as assessed using the ODI. Results Overall LBP prevalence was 15.7%, with no statistically significant differences observed by age or gender. The activities of standing, traveling, and walking were most severely affected. Of those with LBP, 10.3% were considered “crippled” based on ODI responses, whereas a further 31.8% were “severely disabled.” No statistically significant relationship between LBP severity and age or gender was found. Conclusions LBP is a cause of significant disability within this region of rural Ghana; however, prevalence appears to be lower than in the developed world and parts of the urbanized developing world. Increased attention to screening and treatment of LBP represents an opportunity to improve the health of rural Africans. Level of Evidence IV.

show abstract

Management of Low Back Pain in Ghana: A Survey of Self-reported Practice

Abstract: Background and purpose: Practice variation exists in the physiotherapy

Cited by 22 publications

References 38 publications

Determinants of healthcare utilisation for low back pain: A population‐based study in Ethiopia

Determinants of healthcare utilisation for low back pain: A population‐based study in Ethiopia

Do physical therapists follow evidence-based guidelines when managing musculoskeletal conditions? Systematic review

Prevalence and Characteristics of Low Back Pain in a Rural Ghana Primary Care Clinic Population

Contact Info

Product

Resources

About