Pain as a reason for primary care visits: cross-sectional survey in a rural and periurban health clinic in the Eastern Cape, South Africa

Abstract

Background: The burden of pain in primary care has not been described for South Africa. This study aimed to determine the prevalence of pain in primary care and to characterise pain among adult patients attending a rural and a periurban clinic in the Eastern Cape (EC) Province. Method:A cross-sectional descriptive survey was conducted among adult patients attending a rural and periurban clinic over four days. Consecutive patients were asked whether they were in the clinic because of pain and whether the pain was the major reason for their visit. Pain was characterised using an adaptation of the Brief Pain Inventory and the Pain Disability Index. The prevalence percentage and the 95% confidence interval (CI) of pain were estimated, and the relationship with demographic variables was determined at a significance level of P < 0.05.Results: Seven hundred and ninety-six adult patients were interviewed, representing a response rate of 97.4%. Almost three-quarters (74.6%; 95% CI: 63.2-81.4%) reported visiting the clinic because of pain. Pain was the primary reason for 393 (49.4%; 95% CI: 32.1-61.0%) visits and was secondary in 201 (25.3%; 95% CI: 12.8-33.7%) visits. The common sites of pain were the head, back and chest. The median pain score was eight on a scale of 0-10 (interquartile range: 6-8).Respondents experienced limitations in a number of activities of daily living as a result of pain. Conclusion:Pain is a central problem in public primary care settings in the EC Province and must therefore be a priority area for primary care research. Strategies are needed to develop to improve pain management at primary care level in the province.Peer reviewed.

Sleep Quality among Primary Care Attendees in Kaduna, Northern Nigeria: A Case-Control Study

“…More than half of the patients reported that they had pain. This is similar to previous reports that pain is a common complaint in general medical practice [21,22]. About two-thirds of the patients had anxiety symptoms while close to a half had depressive symptoms.…”

Pain knowledge and attitudes of final-year medical students at the University of Cape Town: A cross-sectional survey

“…Despite pain being the most common symptom that patients present with to hospital, healthcare workers inadequately assess and treat pain. 5 This study evaluates the pain knowledge and attitudes of 2018 final-year medical students (104 students, 44.8%). Our sample size allows 90% confidence in the findings.…”

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“…1 The World Health Organization (WHO) has estimated that worldwide 22% of primary care patients suffer from chronic debilitating pain, with chronic pain accounting for one-fifth of physician's visits. 2,3,4 In South Africa (SA), 75% of patients attending an Eastern Cape rural and peri-urban health clinic visited the clinic because of pain, 5 and in a survey of 1066 patients attending primary healthcare facilities in South-West Tshwane (SA), the prevalence of chronic pain was 41%. 6 being typically presented as part of general required courses.…”

An update on available pain medications

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