{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T15:28:24Z","timestamp":1769009304491,"version":"3.49.0"},"reference-count":49,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,7,28]],"date-time":"2025-07-28T00:00:00Z","timestamp":1753660800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European Journal of Pain"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The association between different patterns of healthcare use and non\u2010recovery in patients with spinal disorders is unclear. We aimed to assess the association between healthcare use and non\u2010recovery 6\u2009months after a specialist evaluation in Norwegian secondary care and whether non\u2010recovery was linked to adherence to specialist\u2010recommended care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This observational registry\u2010based cohort study includes 3745 patients aged 18\u201370\u2009years (mean (SD) 46 (12) years, 59% women) from the Norwegian Neck and Back Registry (NNRR). We studied non\u2010recovery 6\u2009months after the specialist evaluation using the Global Perceived Effect (GPE) scale, defined as \u2018slightly improved\u2019, \u2018unchanged\u2019, \u2018slightly worse\u2019, \u2018much worse\u2019, or \u2018worse than ever\u2019. Using logistic regression, we examined the association between non\u2010recovery and specialist\u2010recommended healthcare (i.e., recommended follow\u2010up in primary or secondary care) and actual healthcare use identified in national registries (visits to general practitioners, physical therapists, and chiropractors in primary care and outpatient and inpatient visits in secondary care).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In total, 80% self\u2010reported non\u2010recovery at 6\u2009months. Adherence to specialist\u2010recommended healthcare was not associated with non\u2010recovery (adjusted OR [aOR] 1.09, 95% CI 0.91\u20131.29). Highest odds for non\u2010recovery were among patients\u00a0using primary care alone (aOR 1.68, 95% CI 1.37\u20132.07) or no healthcare (aOR 1.81, 95% CI 1.44\u20132.27). Secondary care alone (aOR 0.75, 95% CI 0.59\u20130.96) or combined with primary care (aOR 0.49, 95% CI 0.41\u20130.59) was associated with recovery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our findings raise questions about the value of the specialist recommendations and also the content of healthcare services provided after a specialist evaluation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance Statement<\/jats:title>\n                    <jats:p>Our findings suggest that follow\u2010up after specialist evaluation may not adequately meet patient needs, indicating a need for improved management of spinal disorders. Given the low proportion of patients reporting recovery at 6\u2010month follow\u2010up, we highlight the importance of good transitions, care coordination, and coherent messages across sectors and professions. More effective healthcare and reduced sick leave could save societal costs. Moreover, this approach could improve quality of life, enabling a more active and participatory lifestyle.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejp.70074","type":"journal-article","created":{"date-parts":[[2025,7,29]],"date-time":"2025-07-29T04:09:36Z","timestamp":1753762176000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Healthcare Use and Non\u2010Recovery in Patients With Spinal Disorders"],"prefix":"10.1002","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-4095-9667","authenticated-orcid":false,"given":"Lise Grethe","family":"Kj\u00f8n\u00f8","sequence":"first","affiliation":[{"name":"Department of Rehabilitation Science and Health Technology, Faculty of Health Sciences Oslo Metropolitan University  Oslo Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marianne Bakke","family":"Johnsen","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Science and Health Technology, Faculty of Health Sciences Oslo Metropolitan University  Oslo Norway"},{"name":"Department of Physical Medicine and Rehabilitation Oslo University Hospital  Oslo Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Margreth","family":"Grotle","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Science and Health Technology, Faculty of Health Sciences Oslo Metropolitan University  Oslo Norway"},{"name":"Department of Research and Innovation, Division of Clinical Neuroscience Oslo University Hospital  Oslo Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan","family":"Hartvigsen","sequence":"additional","affiliation":[{"name":"Center for Muscle and Joint Health, Department of Sports Science and Clinical Biomechanics University of Southern Denmark  Odense Denmark"},{"name":"Chiropractic Knowledge Hub  Odense Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stine","family":"Clausen","sequence":"additional","affiliation":[{"name":"Center for Muscle and Joint Health, Department of Sports Science and Clinical Biomechanics University of Southern Denmark  Odense Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maja","family":"Wilhelmsen","sequence":"additional","affiliation":[{"name":"UiT\u2014The Arctic University of Norway, Faculty of Health Sciences Department of Clinical Medicine  Troms\u00f8 Norway"},{"name":"University Hospital of North Norway Department of Rehabilitation  Troms\u00f8 Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K\u00e5re R\u00f8nn","family":"Richardsen","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Science and Health Technology, Faculty of Health Sciences Oslo Metropolitan University  Oslo Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kjersti","family":"Storheim","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Science and Health Technology, Faculty of Health Sciences Oslo Metropolitan University  Oslo Norway"},{"name":"Department of Research and Innovation, Division of Clinical Neuroscience Oslo University Hospital  Oslo Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karin","family":"Magnusson","sequence":"additional","affiliation":[{"name":"Cluster for Health Services Research Norwegian Institute of Public Health  Oslo Norway"},{"name":"Clinical Epidemiology Unit, Department of Clinical Sciences, Orthopaedics, Faculty of Medicine Lund University  Lund Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,7,28]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102024\u2010096992"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010024\u201053879\u20103"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejp.2310"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0229265"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11136\u2010006\u20109109\u20109"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/bs.3830190102"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2004.09.012"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2007.09.005"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00586\u2010013\u20103149\u2010y"},{"issue":"8","key":"e_1_2_9_11_1","first-page":"271","article-title":"The Oswestry Low Back Pain Disability Questionnaire","volume":"66","author":"Fairbank J. 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