Only 8 percent of patients suffering from back pain receive physical therapy prescriptions

31.08.2015 17:28

Stretching and stretching, bending and kneading, but to no avail: your back hurts again. 7 out of 10 Germans experience this for at least several days a year - sometimes they struggle with back pain for weeks, months or even constantly.[1] But more exercise, painkillers and massages don't always help. At least for muscular causes, physiotherapy can be helpful by regulating the tension in the muscles by moving the relevant joints. But does every patient with back pain receive a prescription? A study by IMS Health addressed this question

The aims were, on the one hand, to assess how many patients with back pain receive physiotherapy treatment and, on the other hand, which factors influence whether a patient is prescribed physiotherapy treatment. For this purpose, all anonymized patients with a confirmed back pain diagnosis (ICD 10: M54) from September 2009 to August 2014 from the IMS® Disease Analyzer database were examined. The researchers selected the patients into two groups: those who were prescribed physical therapy and those who were not prescribed. In addition to the physiotherapy prescription, the researchers also looked at other influencing factors, such as age, gender, type of insurance (statutory/private), practice area (east/west), smoking status and co-diagnoses (including obesity, heart failure, peripheral arterial occlusive disease).

Privately insured people are more likely to be prescribed

The retrospective case-control study included 1,706,054 patients with a confirmed diagnosis of back pain across all specialist groups over the specified 5-year period. Only 7.9 percent of patients (136,472) received a physiotherapy prescription, 92.1 percent of patients (1,569,582) did not. Those with a prescription were on average 52.8 years old, 56.7 percent were female and 16.2 percent were privately insured - well above the rate of those with private health insurance of around 11 percent[2]. The other group was characterized by an average age of 53.7 years, 51.9 percent women and 11.4 percent private insurance. Accordingly, there is a connection between physiotherapy prescriptions when diagnosing back pain and male gender, younger age and those with full private insurance. “The increased number of privately insured people among those who received a prescription suggests greater financial pressure on those insured by statutory health insurance,” sums up Silvia Dombrowski, researcher from the epidemiology team at IMS Health. However, other studies by the team showed that there are hardly any significant differences between those insured by statutory or private health insurance when prescribing painkillers such as analgesics for back pain.

Other factors influencing the likelihood of prescription

Furthermore, the results of the retrospective case-control study showed that a doctor's practice in West Germany had a higher probability of prescribing physiotherapy. On the other hand, heart failure, smoking, obesity and peripheral arterial disease had a negative impact on possible prescription. “In order to understand why certain co-diagnoses are associated with an increased or reduced probability of physiotherapy prescription, further studies must be carried out,” says Prof. Dr. Karel Kostev, Senior Research Advisor at IMS Health.