Knee pain and osteoarthritis in the general population: what influences patients to consult?

We examined the relationship between predisposing factors, enabling factors and need-related factors with consultation for knee pain in general practice. This was a retrospective review of computerized medical records for knee-related consultations in the 18 months before baseline assessment of individuals aged over 50 years reporting knee pain in the previous 12 months. The association between each factor and consultation for consulters compared to non-consulters was summarized using odds ratios (ORs). Interaction between each variable and chronic pain grade was investigated. The association between knee-related consultation and the number and type of other co-morbid consultations was then determined. In total, 742 participants were assessed. Of these, 209 (28%) had a knee-related consultation in the previous 18 months. Recent onset of pain [OR 3.2; 95% confidence interval (95% CI) 1.8, 5.7] and severity of pain, Grade III/IV (OR 3.4; 95% CI 2.1, 5.6), were associated with knee-related consultation. Those rating their knee problem as a health priority were more likely to consult (OR 3.2; 95% CI 1.6, 6.7). Irrespective of knee pain severity, there was no difference in the median number of co-morbid consultations between knee consulters and knee non-consulters. Need-related factors appeared to be associated with the decision to consult about knee pain. Neither the presence of self-reported selected co-morbid conditions nor the total number of co-morbid conditions was related to consultations for knee pain. Nevertheless, 50% of those with severely disabling knee pain still did not consult for it. Further investigation of this is important in order to optimize care for patients with knee pain and co-morbid disease.