Article

Treatment of carpal tunnel syndrome (CTS) in commercially insured
patients across the spectrum of provider types rarely has been described.
OBJECTIVE: To describe patterns of types of treatment for patients with CTS using
a large commercial insurance database. DESIGN:
Retrospective cohort descriptive
study. SETTING: Administrative health data from the Clinformatics Data Mart
(OptumInsight, Eden Prairie, MN). PATIENTS: Adults with a primary diagnosis of
CTS seen from between January 2010 to December 2012 who had a total of 48 months
of continuous data (12 months before diagnosis and 36 months after diagnosis) (n
= 24,931). OUTCOMES: Frequency of types of treatment (heat, manual therapy,
positioning, steroids, stretching, surgery) by number of treatments, number of
visits, provider type, and characteristics. RESULTS:
Fifty-four percent of
patients received no reported treatment, and 50.4% had no additional visits.
Surgery (42.5%) and positioning (39.8%) were the most frequent single treatments.
Patients who were seen by orthopedist for their first visit more frequently
received some treatment (75.1%) and at least 1 additional visit (74.1%) compared
with those seen by general practitioners (59.5%, 57.5%, respectively) or other
providers (65.4%, 68.4, respectively). Orthopedists more frequently prescribed
positioning devices (26.8%) and surgery (36.8%) than general practitioners
(18.8%, 14.1%, respectively) or other providers (15.7%, 19.7%, respectively).
Older adults more frequently had CTS surgery, as did people who lived in the
Midwest. Overall, only 24% of patients with CTS had surgery. CONCLUSIONS: For
more than one-half of patients with CTS no treatment was provided after an
initial visit. Surgery rates were much lower than what has previously been
reported in the literature. Generally, patients with CTS receive treatments that
are supported by current treatment guidelines.
LEVEL OF EVIDENCE: NA.
CI - Copyright (c) 2018 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS