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Patients' and clinicians' perspectives towards primary care consultations for shoulder pain: qualitative findings from the Prognostic and Diagnostic Assessment of the Shoulder (PANDA-S) programme.

Saunders, Ben; Burton, Claire; van der Windt, Danielle A.; Myers, Helen; Chester, R.; Pincus, T.; Wynne-Jones, Gwenllian

Patients' and clinicians' perspectives towards primary care consultations for shoulder pain: qualitative findings from the Prognostic and Diagnostic Assessment of the Shoulder (PANDA-S) programme. Thumbnail


Authors

Helen Myers

R. Chester

T. Pincus



Abstract

BACKGROUND: Clinical management of musculoskeletal shoulder pain can be challenging due to diagnostic uncertainty, variable prognosis and limited evidence for long-term treatment benefits. The UK-based PANDA-S programme (Prognostic And Diagnostic Assessment of the Shoulder) is investigating short and long-term shoulder pain outcomes. This paper reports linked qualitative research exploring patients' and clinicians' views towards primary care consultations for shoulder pain. METHODS: Semi-structured interviews were conducted with 24 patients and 15 primary care clinicians. Twenty-two interviews (11 patients, 11 clinicians) were conducted as matched patient-clinician 'dyads'. Data were analysed thematically. RESULTS: Clinicians reported attempts to involve patients in management decisions; however, there was variation in whether patients preferred treatment choice, or for decisions to be clinician-led. Some patients felt uncertain about the decisions made, due to a lack of discussion about available management options. Many General Practitioners expressed a lack of confidence in diagnosing the underlying cause of shoulder pain. Patients reported either not being given a diagnosis, or receiving different diagnoses from different professionals, resulting in confusion. Whilst clinicians reported routinely discussing prognosis of shoulder pain, patients reported that prognosis was not raised. Patients also expressed concern that their shoulder pain could be caused by serious pathology; however, clinicians felt that this was not a common concern for patients. CONCLUSIONS: Findings showed disparities between patients' and clinicians' views towards shoulder pain consultations, indicating a need for improved patient-clinician communication. Findings will inform the design of an intervention to support treatment and referral decisions for shoulder pain that will be tested in a randomised controlled trial.

Citation

Saunders, B., Burton, C., van der Windt, D. A., Myers, H., Chester, R., Pincus, T., & Wynne-Jones, G. (2023). Patients' and clinicians' perspectives towards primary care consultations for shoulder pain: qualitative findings from the Prognostic and Diagnostic Assessment of the Shoulder (PANDA-S) programme. BMC Musculoskeletal Disorders, 24, Article 1. https://doi.org/10.1186/s12891-022-06059-1

Journal Article Type Article
Acceptance Date Dec 6, 2022
Online Publication Date Jan 2, 2023
Publication Date 2023-01
Journal BMC Musculoskeletal Disorders
Print ISSN 1471-2474
Electronic ISSN 1471-2474
Publisher BioMed Central
Peer Reviewed Peer Reviewed
Volume 24
Article Number 1
DOI https://doi.org/10.1186/s12891-022-06059-1
Keywords Shoulder pain; Primary care; General practice; Diagnosis; Prognosis; Qualitative
Publisher URL https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/s12891-022-06059-1
PMID 36588148