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However, the influence of health and lifestyle factors remains unclear, and the potential confounding effects of aggregated familial factors (including genetics and the early shared environment) has not been considered extensively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A cross\u2010sectional analysis was performed on 1605 twins enrolled in the Murcia Twin Registry (Spain). The outcome was seeking medical care for LBP and various self\u2010reported demographic, health and lifestyle factors were considered predictors. All variables except sleep quality and diabetes were collected in 2013, which were cross\u2010referenced from 2009 to 2010. A multivariate logistic regression model was performed on the total sample, followed by a co\u2010twin case\u2013control analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The only significant factor found to increase the odds of seeking medical care for LBP without being affected by familial factors was poor sleep quality (total sample OR\u00a0=\u00a01.58, 95%CI 1.24\u20132.01; case\u2013control OR\u00a0=\u00a01.75, 95%CI 1.14\u20132.69). The factors that were associated with reduced odds of seeking medical care for LBP and not confounded by familial factors were male sex (case\u2013control OR\u00a0=\u00a00.55, 95%CI 0.33\u20130.93), alcohol intake (case\u2013control OR\u00a0=\u00a00.90, 95%CI 0.82\u20130.99) and a history of diabetes (case\u2013control OR\u00a0=\u00a00.50, 95%CI 0.25\u20130.97). No other factors significantly influenced medical care\u2010seeking for LBP.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>People reporting poor sleep quality are more likely to seek medical care for LBP in the long term, with this relationship being independent from aggregated familial factors. Conversely, males, people reporting higher alcohol intake, and people with a history of diabetes are less likely to seek medical care for LBP.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>This is the first study investigating the factors that influence seeking medical care for LBP, while adjusting for the influence of familial factors using a co\u2010twin control design. Poor sleep quality is associated with seeking medical care for LBP in the long term and does not appear to be confounded by familial factors. Early screening for indicators of poor sleep quality and appropriate referral to interventions for improving sleep quality or reducing pain in sleep may improve LBP management.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ejp.1731","type":"journal-article","created":{"date-parts":[[2021,1,20]],"date-time":"2021-01-20T10:47:17Z","timestamp":1611139637000},"page":"1091-1106","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Factors associated with seeking medical care for low back pain in a twin adult sample"],"prefix":"10.1002","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2479-0081","authenticated-orcid":false,"given":"Emma Kwan\u2010Yee","family":"Ho","sequence":"first","affiliation":[{"name":"School of Health Sciences Faculty of Medicine and Health The University of Sydney Sydney NSW Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3479-0683","authenticated-orcid":false,"given":"Manuela","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Institute of Bone and Joint Research Northern Clinical School Faculty of Medicine and Health The University of Sydney Sydney NSW Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7459-5105","authenticated-orcid":false,"given":"Marina","family":"Pinheiro","sequence":"additional","affiliation":[{"name":"School of Health Sciences Faculty of Medicine and Health The University of Sydney Sydney NSW Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0079-4862","authenticated-orcid":false,"given":"Ana Paula","family":"Carvalho\u2010e\u2010Silva","sequence":"additional","affiliation":[{"name":"School of Health Sciences Faculty of Medicine and Health The University of Sydney Sydney NSW Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3450-1159","authenticated-orcid":false,"given":"Juan Jose","family":"Madrid\u2010Valero","sequence":"additional","affiliation":[{"name":"Department of Human Anatomy and Psychobiology and Murcia Institute for Biomedical Research (IMIB\u2010Arrixaca\u2010UMU) University of Murcia Murica Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8981-2125","authenticated-orcid":false,"given":"Joshua","family":"Zadro","sequence":"additional","affiliation":[{"name":"The University of Sydney Institute for Musculoskeletal Health Sydney School of Public Health Sydney NSW Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7779-6017","authenticated-orcid":false,"given":"Juan","family":"Ordo\u00f1ana","sequence":"additional","affiliation":[{"name":"Department of Human Anatomy and Psychobiology and Murcia Institute for Biomedical Research (IMIB\u2010Arrixaca\u2010UMU) University of Murcia Murica Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5861-7770","authenticated-orcid":false,"given":"Paulo","family":"Ferreira","sequence":"additional","affiliation":[{"name":"School of Health Sciences Faculty of Medicine and Health The University of Sydney Sydney NSW Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,2,16]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/fampra\/cmn065"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-016-3586-5"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-010-1661-x"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejp.1491"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1360-0443.98.s1.2.x"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-019-1351-4"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-017-0247-x"},{"key":"e_1_2_9_9_1","article-title":"Health\u2010care utilisation for low back pain: A systematic review and meta\u2010analysis of population\u2010based observational studies","volume":"1","author":"Beyera G. 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