Pain as a reason for primary care visits: cross-sectional survey in a rural and periurban health clinic in the Eastern Cape, South Africa

  • Ehimario Uche Igumbor University of the Western Cape
  • Thandi Puoane University of the Western Cape
  • Stuart A Gansky University of California
  • Octavia Plesh University of California
Keywords: Pain, Consultation, Primary Care, Clinic Visits,

Abstract

Background: The burden of pain in primary care has not been described for South Africa. This study aimed to determine the prevalence of pain in primary care and to characterise pain among adult patients attending a rural and a periurban clinic in the Eastern Cape (EC) Province. Method: A cross-sectional descriptive survey was conducted among adult patients attending a rural and periurban clinic over four days. Consecutive patients were asked whether they were in the clinic because of pain and whether the pain was the major reason for their visit. Pain was characterised using an adaptation of the Brief Pain Inventory and the Pain Disability Index. The prevalence percentage and the 95% confidence interval (CI) of pain were estimated, and the relationship with demographic variables was determined at a significance level of P < 0.05. Results: Seven hundred and ninety-six adult patients were interviewed, representing a response rate of 97.4%. Almost three-quarters (74.6%; 95% CI: 63.2-81.4%) reported visiting the clinic because of pain. Pain was the primary reason for 393 (49.4%; 95% CI: 32.1-61.0%) visits and was secondary in 201 (25.3%; 95% CI: 12.8-33.7%) visits. The common sites of pain were the head, back and chest. The median pain score was eight on a scale of 0-10 (interquartile range: 6-8). Respondents experienced limitations in a number of activities of daily living as a result of pain. Conclusion: Pain is a central problem in public primary care settings in the EC Province and must therefore be a priority area for primary care research. Strategies are needed to develop to improve pain management at primary care level in the province.

Author Biographies

Ehimario Uche Igumbor, University of the Western Cape
MPH, PhD Senior Lecturer: Epidemiology & Health Information Systems School of Public Health University of the Western Cape Bellville 7535 South Africa
Thandi Puoane, University of the Western Cape
Professor of Public Health School of Public Health University of the Western Cape
Stuart A Gansky, University of California
Associate Professor School of Dentistry University of California San Francisco USA
Octavia Plesh, University of California
Professor School of Dentistry University of California San Francisco USA
Published
2011-11-15
Section
Original Research