Work participation in primary care consulters for musculoskeletal conditions

PROBLEM:

The impact of musculoskeletal conditions on work is a common reason for consultation to primary care. Whilst primary care electronic health records provide information on the issue of fit notes, employment status and the extent of work absence (time taken off work whilst in employment) and presenteeism (lost productivity at work) is unclear in consulters for musculoskeletal conditions. The aims of this study were to describe employment status in primary care consulters for common musculoskeletal conditions aged 35 to 65, the extent of absenteeism and presenteeism and how these levels differ by condition. 

APPROACH:

Data was used from the PRELIM initiative, a cross-sectional study of adults aged ≥35 years registered with one of eleven general practices in North Staffordshire or Stoke-on-Trent clinical commissioning groups. Analysis included responders to a survey who (i) consulted primary care in the previous 12 months for one of seven common musculoskeletal conditions (back, neck, hip, hand, knee or shoulder pain or osteoarthritis (n=2001)) and/or (ii) belonged to a general population sample (n=2154). Employment status was measured using a single item. Work Absence and Productivity was measured using the Work Productivity and Activity Impairment.

LEARNING

Employment rate was lower (76.3% cf 70.7%) and levels of absenteeism (4.7% cf 8.5%) and presenteeism (28.7% cf 45.0%) were higher in the general population to those who consulted for a musculoskeletal condition. Consulters for OA had the lowest employment rate (61.0%) and highest level of presenteeism (52.40%), whereas neck pain showed the highest rate of absenteeism. 

WHY IT MATTERS:

The extent of the impact of musculoskeletal conditions on work indicates a need for primary care clinicians to target improving work outcomes for the large number of consulters with musculoskeletal conditions. This will may involve greater linkage with employers and a multidisciplinary approach to reduce the barriers to work participation.

Presenting author: Lauren Franklin

Email: w9q63@students.keele.ac.uk        Twitter: @MedwithLauren  

Authors: Lauren Franklin1, Ross Wilkie1

Affiliation: 1 School of Medicine, Keele University, Staffordshire ST5 5BG, UK