caa a22 4500 445832533 CHVBK 20180317145320.0 cr unu---uuuuu 170323e20111201xx s 000 0 eng 10.1007/s00586-011-1780-z doi (NATIONALLICENCE)springer-10.1007/s00586-011-1780-z Benchmarking clinical management of spinal and non-spinal disorders using quality of life: results from the EPI3-LASER survey in primary care [Elektronische Daten] [Michel Rossignol, Bernard Begaud, Bernard Avouac, France Lert, Frederic Rouillon, Jacques Bénichou, Jacques Massol, Gerard Duru, Anne-Marie Magnier, Didier Guillemot, Lamiae Grimaldi-Bensouda, Lucien Abenhaim] Concerns have been raised regarding sub-optimal utilization of analgesics and psychotropic drugs in the treatment of patients with chronic musculoskeletal disorders (MSDs) and their associated co-morbidities. The objective of this study was to describe drug prescriptions for the management of spinal and non-spinal MSDs contrasted against a standardized measure of quality of life. A representative population sample of 1,756 MSDs patients [38.5% with spinal disorder (SD) and 61.5% with non-spinal MSDs (NS-MSD)] was drawn from the EPI3-LASER survey of 825 general practitioners (GPs) in France. Physicians recorded their diagnoses and prescriptions on that day. Patients provided information on socio-demographics, lifestyle and quality of life using the Short Form 12 (SF-12) questionnaire. Chronicity of MSDs was defined as more than 12weeks duration of the current episode. Chronic SD and NS-MSD patients were prescribed less analgesics and non-steroidal anti-inflammatory drugs than their non-chronic counterpart [odds ratios (OR) and 95% confidence intervals (CI), respectively: 0.4, 0.2-0.7 and 0.5, 0.3-0.6]. They also had more anxio-depressive co-morbidities reported by their physicians (SD: 16.1 vs.7.4%; NS-MSD: 21.6 vs. 9.5%) who prescribed more antidepressants and anxiolytics with a difference that was statistically significant only for spinal disorder patients (OR, 95% CI: 2.0, 1.1-3.6). Psychotropic drugs were more often prescribed in patients in the lower quartile of SF-12 mental score and prescriptions of analgesics in the lower quartile of SF-12 physical score (P<0.001). In conclusion, anxiety and depressive disorders were commonly reported by GPs among chronic MSD patients. Their prescriptions of psychotropic and analgesic drugs were consistent with patients' self-rated mental and physical health. The Author(s), 2011 Spinal disorders nationallicence Musculoskeletal disorders nationallicence Epidemiology nationallicence Population health nationallicence Rossignol Michel Department of Epidemiology, Biostatistics and Occupational Health, McGill University, 4820 Boulevard Saint-Laurent, H2T 1R5, Montreal, QC, Canada aut Begaud Bernard Université de Bordeaux, U657, 33000, Bordeaux, France aut Avouac Bernard LA-SER, Paris, France aut Lert France INSERM U1018, Center for Epidemiology and Population Health, Villejuif, France aut Rouillon Frederic Centre Hospitalier Sainte-Anne, Université Paris V René Descartes, Paris, France aut Bénichou Jacques INSERM U657, University of Rouen, Rouen, France aut Massol Jacques Université Franche-Comté, CHU de Besançon, Besançon, France aut Duru Gerard CNRS (French National Center for Scientific Research), Université Claude Bernard, Lyon, France aut Magnier Anne-Marie Faculté de Médecine Université Pierre et Marie Curie, Paris, France aut Guillemot Didier Institut Pasteur and Université Paris-Ile de France Ouest, Paris, France aut Grimaldi-Bensouda Lamiae LA-SER, Paris, France aut Abenhaim Lucien LA-SER Europe Ltd, London, UK aut European Spine Journal Springer-Verlag 20/12(2011-12-01), 2210-2216 0940-6719 20:12<2210 2011 20 586 https://doi.org/10.1007/s00586-011-1780-z text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00586-011-1780-z text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Rossignol Michel Department of Epidemiology, Biostatistics and Occupational Health, McGill University, 4820 Boulevard Saint-Laurent, H2T 1R5, Montreal, QC, Canada aut NATIONALLICENCE 700 1- Begaud Bernard Université de Bordeaux, U657, 33000, Bordeaux, France aut NATIONALLICENCE 700 1- Avouac Bernard LA-SER, Paris, France aut NATIONALLICENCE 700 1- Lert France INSERM U1018, Center for Epidemiology and Population Health, Villejuif, France aut NATIONALLICENCE 700 1- Rouillon Frederic Centre Hospitalier Sainte-Anne, Université Paris V René Descartes, Paris, France aut NATIONALLICENCE 700 1- Bénichou Jacques INSERM U657, University of Rouen, Rouen, France aut NATIONALLICENCE 700 1- Massol Jacques Université Franche-Comté, CHU de Besançon, Besançon, France aut NATIONALLICENCE 700 1- Duru Gerard CNRS (French National Center for Scientific Research), Université Claude Bernard, Lyon, France aut NATIONALLICENCE 700 1- Magnier Anne-Marie Faculté de Médecine Université Pierre et Marie Curie, Paris, France aut NATIONALLICENCE 700 1- Guillemot Didier Institut Pasteur and Université Paris-Ile de France Ouest, Paris, France aut NATIONALLICENCE 700 1- Grimaldi-Bensouda Lamiae LA-SER, Paris, France aut NATIONALLICENCE 700 1- Abenhaim Lucien LA-SER Europe Ltd, London, UK aut NATIONALLICENCE 773 0- European Spine Journal Springer-Verlag 20/12(2011-12-01), 2210-2216 0940-6719 20:12<2210 2011 20 586 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer