Chronic low back pain patient groups in primary care--a cross sectional cluster analysis
- PMID: 24131707
- PMCID: PMC3852748
- DOI: 10.1186/1471-2474-14-294
Chronic low back pain patient groups in primary care--a cross sectional cluster analysis
Abstract
Background: Due to the heterogeneous nature of chronic low back pain (CLBP), it is necessary to identify patient groups and evaluate treatments within these groups. We aimed to identify groups of patients with CLBP in the primary care setting.
Methods: We performed a k-means cluster analysis on a large data set (n = 634) of primary care patients with CLBP. Variables of sociodemographic data, pain characteristics, psychological status (i.e., depression, anxiety, somatization), and the patient resources of resilience and coping strategies were included.
Results: We found three clusters that can be characterized as "pensioners with age-associated pain caused by degenerative diseases", "middle-aged patients with high mental distress and poor coping resources", and "middle-aged patients who are less pain-affected and better positioned with regard to their mental health".
Conclusions: Our results supported current knowledge concerning groups of CLBP patients in primary care. In particular, we identified a group that was most disabled and distressed, and which was mainly characterized by psychological variables. As shown in our study, pain-related coping strategies and resilience were low in these patients and might be addressed in differentiating treatment strategies. Future studies should focus on the identification of this group in order to achieve effective treatment allocation.
Trial registration: German Clinical Trial Register DRKS00003123.
Similar articles
-
Psychological risk and protective factors for disability in chronic low back pain - a longitudinal analysis in primary care.BMC Musculoskelet Disord. 2017 Mar 20;18(1):114. doi: 10.1186/s12891-017-1482-8. BMC Musculoskelet Disord. 2017. PMID: 28320375 Free PMC article. Clinical Trial.
-
Study protocol: Transition from localized low back pain to chronic widespread pain in general practice: identification of risk factors, preventive factors and key elements for treatment--a cohort study.BMC Musculoskelet Disord. 2012 May 25;13:77. doi: 10.1186/1471-2474-13-77. BMC Musculoskelet Disord. 2012. PMID: 22630134 Free PMC article.
-
Even Worse - Risk Factors and Protective Factors for Transition from Chronic Localized Low Back Pain to Chronic Widespread Pain in General Practice: A Cohort Study.Spine (Phila Pa 1976). 2015 Aug 1;40(15):E890-9. doi: 10.1097/BRS.0000000000000980. Spine (Phila Pa 1976). 2015. PMID: 25955187
-
Differences between patients with chronic widespread pain and local chronic low back pain in primary care--a comparative cross-sectional analysis.BMC Musculoskelet Disord. 2013 Dec 13;14:351. doi: 10.1186/1471-2474-14-351. BMC Musculoskelet Disord. 2013. PMID: 24330525 Free PMC article.
-
Effectiveness of Primary Care Interventions Using a Biopsychosocial Approach in Chronic Low Back Pain: A Systematic Review.Pain Pract. 2019 Feb;19(2):224-241. doi: 10.1111/papr.12735. Epub 2018 Dec 2. Pain Pract. 2019. PMID: 30290052 Free PMC article.
Cited by
-
Recognition of patients with medically unexplained physical symptoms by family physicians: results of a focus group study.BMC Fam Pract. 2016 May 12;17:55. doi: 10.1186/s12875-016-0451-x. BMC Fam Pract. 2016. PMID: 27175489 Free PMC article.
-
Subgroups in chronic low back pain patients - a step toward cluster-based, tailored treatment in inpatient standard care: On the need for precise targeting of treatment for chronic low back pain.Ger Med Sci. 2019 Sep 11;17:Doc09. doi: 10.3205/000275. eCollection 2019. Ger Med Sci. 2019. PMID: 31728134 Free PMC article.
-
The epidemiology of chronic pain in Libya: a cross-sectional telephone survey.BMC Public Health. 2016 Aug 11;16(1):776. doi: 10.1186/s12889-016-3349-6. BMC Public Health. 2016. PMID: 27514513 Free PMC article.
-
Only two subscales of the Coping Strategies Questionnaire are culturally relevant for people with chronic low back pain in Nigerian Igbo populations: a cross-cultural adaptation and validation study.J Patient Rep Outcomes. 2021 Sep 8;5(1):85. doi: 10.1186/s41687-021-00367-1. J Patient Rep Outcomes. 2021. PMID: 34495431 Free PMC article.
-
The Use of Cluster Analysis by Partitioning around Medoids (PAM) to Examine the Heterogeneity of Patients with Low Back Pain within Subgroups of the Treatment Based Classification System.J Biomed Phys Eng. 2023 Feb 1;13(1):89-98. doi: 10.31661/jbpe.v0i0.2001-1047. eCollection 2023 Feb. J Biomed Phys Eng. 2023. PMID: 36818010 Free PMC article.
References
-
- Bundesärztekammer (BÄK), Kassenärztliche Bundesvereinigung (KBV), Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF) Nationale Versorgungsleitlinie Kreuzschmerz – Langfassung. [National guideline for low back pain - long version]. Version 1.2. Berlin; 2011.
-
- Dietl MKD. Versorgungssituation in der Schmerztherapie in Deutschland im internationalen Vergleich hinsichtlich Über-, Unter- oder Fehlversorgung: HTA-Bericht. Köln: [Health care services of pain therapy in Germany – an international comparison regarding to over-, undersupply and inappropriate health care services]; 2011.
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Other Literature Sources
Research Materials