Physician consultation rates and characteristics among workers with chronic pain or headache who participated in a behavioural change program: a retrospective database analysis using real-world healthcare data

Abstract

Objective: To assess the potential benefit of a behavioural change programme in working individuals with chronic pain or headache, in the form of increased physician consultation.

Design: Retrospective observational database study.

Setting: Members of employment-based healthcare insurance in Japan.

Participants: Individual-level data of working individuals aged <75 years from November 2019 through March 2020 were extracted from a database managed by MinaCare Co., Ltd. Included individuals had records of programme participation and chronic pain or headache (self-reported), and did not consult physicians for ≥3 months before programme participation.

Outcome measures: Physician consultation rates after participating in the programme were examined from December 2019 through March 2020, separately for chronic pain and headache. Baseline characteristics included age, pain numeric rating scale (NRS) score (for chronic pain), suspected migraine (for headache), labour productivity including absenteeism and presenteeism, and 4-month indirect costs in Japanese yen (JPY).

Results: The baseline mean age (±SD) of 506 individuals with chronic pain was 46.8±10.1 years; that of 352 individuals with headache was 43.6±9.9 years. Of those with chronic pain, 71.4% had an NRS score≥4, and 49.7% of those with headache had suspected migraine. Overall, 11.3% and 5.4% of those with chronic pain or headache consulted physicians, respectively. The mean baseline absenteeism and presenteeism were 1.5% and 19.1% in those with chronic pain, and 1.5% and 23.0% in those with headache. The baseline indirect costs were 586 941.6 JPY and 1 060 281.6 JPY among those with chronic pain or headache, respectively.

Conclusion: Given that the individuals did not regularly consult physicians before the programme despite reporting substantial symptoms, our results suggest the potential benefit of educational programmes encouraging physician consultation. Further studies are required to evaluate how to effectively implement such educational programmes via healthcare insurers to reduce the burden of pain symptoms and overall medical costs.

Keywords: Back pain; Migraine; Musculoskeletal disorders; Pain management.

Figure 1

Study population for (A) chronic pain or (B) headache. NRS, numeric rating scale.

Figure 2

Timing of the first physician consultation due to pain among individuals with (A) chronic pain or (B) headache. Triangles represent the date when a series of six educational contents were released to participating members via email. The figures include individuals whose date of the first physician consultation was identified in the database. The data could not be identified in the database for those who were dispensed analgesics at visiting hospitals/clinics (ie, not at the pharmacy), and thus, they are not included in these figures.