Frequency of musculoskeletal symptoms and presenting complaints in video-observed primary care consultations with patients aged 45 and over

Background: Most literature relating to musculoskeletal consultations in primary care relies on data collected retrospectively by questioning either GP or patient, or by analysing READ code data. Collecting data using video recordings of consultations has the advantage of being more accurate, avoiding recall bias and coding bias, and also facilitates more in-depth study. This abstract reports early findings from a study of video recorded primary care consultations, which aims to explore the patterns of consultation in patients with musculoskeletal symptoms and to understand more about osteoarthritis (OA) consultations in particular.

Methods: With ethical approval, 5 GPs in 2 practices in Staffordshire have agreed and participated to date. In 2 half day surgeries per GP, patients aged 45 and over, attending routine consultations, were asked to consent to having their consultation video recorded and complete a questionnaire regarding their demographics, symptoms and agenda for the consultation. The video recorded consultations were then viewed by ZP and actual symptoms discussed and diagnosis recorded.

Results: 71.4% of eligible patients agreed to participate. Of those participating, 42.7% were female and 57.3% male, with a mean age of 69 (range 45-91). Table 1 shows the number of patients that reported having joint pain, the proportions of these that intended to, and subsequently did discuss joint pain, along with the diagnosis.

Conclusions: The prevalence of joint pain in patients consulting their GPs has not been reported previously, and the data presented here, albeit from a small sample, suggests that 49.3% of these patients aged 45 and over are experiencing joint pain. Data from local GP databases suggests that 14% of consultations in this age group relate to musculoskeletal symptoms, yet the data from this study suggests a higher proportion (21.3%). Furthermore, this study highlights that a number of patients intend to discuss joint pain but do not ultimately raise this concern with the GP (10.6%).

Further aspects of this study which include qualitative analysis of the consultations and post consultation interviews with participants will provide a fuller picture of the pattern of consultation.