Background: It is estimated that 18.8 million people in the United Kingdom are living with a musculoskeletal (MSK) condition. It is a major cause of morbidity and a significant reason for presentation to primary care.
Aim: To determine the prevalence of MSK conditions presenting for consultation in general practice (GP), and how they are managed.
Design and setting: Epidemiological study.
Method: Patient episode consultations were reviewed at an urban community general practice. This involved evaluating morning consultations over a 1-week period from each of January, April, July, and October 2018. This included all the morning consultations from all GPs present. The number of MSK consultations was recorded, and within that the different presentations and their management plan.
Results: A total of 545 consultations were reviewed, of which 115 were related to an MSK presentation: an overall prevalence of 21.1%. The commonest MSK presentations related to the lumbosacral spine (18.3%) and the knee joint (17.4%). Re-presentations of an existing condition accounted for 73.9% of all MSK consultations. Steroid injections were administered in 33% of knee related consultations.
Conclusion: MSK presentations account for a large proportion of GP workload, but there is currently no mandatory training in orthopedics as part of the GP curriculum. Structured MSK education for GPs is important and may reduce the burden of re-presentations. Competency in joint injection is also an important skill for GPs.
Keywords: consultation; education; epidemiology; general practice; musculoskeletal; orthopedics.
It is a well-known fact that musculoskeletal (MSK) conditions are common in the general population. It is less well known just how commonly they present to the general practitioner (GP), and how they are managed in the United Kingdom within the community setting. This article primarily investigates how frequently MSK conditions present to a typical GP surgery in the United Kingdom. It analyses consultations over different weeks of the year in an urban practice in the north east of England. Within the musculoskeletal consultations, multiple variables are analyzed to investigate other trends. By doing so, the article identifies key findings including: the commonest MSK conditions, the different management decisions made by GPs, and how care for patients with MSK conditions might be improved. This article demonstrates that MSK conditions are so common that they are almost certain to be a daily part of the typical working day for a GP. It demonstrates why MSK training should be a priority for GPs, and where that training should be focused to use minimal resources for maximum benefit.
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