Musculoskeletal foot problems in primary care: what influences older people to consult?

OBJECTIVE To estimate the incidence of, and factors associated with, consultation for musculoskeletal foot problems in primary care. METHODS Survey data from 13 986 people aged ≥50 years who took part in the North Staffordshire Osteoarthritis Project were linked to a database of primary care consultations. Foot problems were defined as responding affirmatively to the questions: 'Have you had any problems with your feet over the last year?' or 'Have you had pain in the last year in and around the foot?'. The main outcome measure was a record of a musculoskeletal foot-related consultation within 18 months following the survey. RESULTS Of the 3858 participants with foot problems who had not consulted before the survey, 350 (9.1%) consulted in the 18 months following the survey. Age, sex, education, general health and pain in other regions were not associated with future consultation. However, those who consulted were more likely to have reported foot pain [adjusted odds ratio (OR) 2.04; 95% CI 1.22, 3.42) and to consider treatments to be effective in controlling disease (OR 1.54; 95% CI 1.07, 2.21) in the baseline survey, and to have been a frequent consulter in the 18 months before the survey (OR 1.65; 95% CI 1.30, 2.09). CONCLUSIONS Only a minority of older people with musculoskeletal foot problems consult their general practitioner about them. Foot pain, frequent consultation for other problems and positive perceptions of treatment efficacy appear to be the strongest factors influencing future consultation.