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Musculoskeletal pain, disability and health-seeking behavior in adult Kuwaitis using a validated Arabic version of the WHO-ILAR COPCORD Core Questionnaire

A.M. Al-Awadhi¹, S.O. Olusi², M. Moussa³, D. Shehab¹, N. Al-Zaid⁴, A. Al-Herz⁵, K. Al-Jarallah¹

¹Department of Medicine, ²Department of Pathology, ³Department of Community Medicine, ⁴Department of Physiology, Faculty of Medicine, Kuwait University; ⁵Mubarak Al-Kabeer Hospital, Ministry of Health, Al-Safat, Kuwait.

ABSTRACT
Objective
The WHO-ILAR Community Oriented Program for Control of Rheumatic Diseases (COPCORD) primarily aims to estimate the burden of musculoskeletal symptoms/disorders. We investigated data on musculoskeletal pain, disability and health-seeking behavior in the first community-based COPCORD study in Kuwait.

Methods
The validated Arabic version of the WHO-ILAR COPCORD Core Questionnaire was used in 2,500 randomly selected Kuwaiti households. The target population comprised Kuwaiti nationals aged 15 years and older. Twenty-four trained field workers completed the survey in 8 weeks. Those subjects reporting musculoskeletal pain were identified (Phase 1), and were asked to complete a self-evaluation questionnaire (Phase 2) prior to rheumatological examination (Phase 3). Phase 2 included questions on the site and severity of pain, traumatic events, functional disability, and treatment. Patients marked their pain sites on a mannequin during their interviews. "Sufferers" were defined as those with musculoskeletal pain and no history of trauma.

Results
A total of 7,670 adults were interviewed (response rate 88%), of whom 2,057 had musculoskeletal pain not related to trauma. Knees, back, and shoulders were the common sites of pain. Most of the sufferers reported the severity of pain as being moderate to severe. Functional disability was reported in 39.1% of the sufferers. The age-sex population adjusted prevalence rate for musculoskeletal pain was 35.7% in females and 20.2% in males. The most common sources for advice on treatment were physicians in hospitals (68.8%) and general practitioners (30.4%). 82% had prescriptions for their medications, while 19.4% had self-prescribed tablets.

Conclusion
Musculoskeletal pain is a major health problem among Kuwaitis and deserves intense government attention.

Key words
Musculoskeletal pain, COPCORD, Kuwait.

This study has been sponsored by the Kuwait University and Kuwait Foundation for Advancement of Science, Grant number MM 01/01 and KFAS 2000.07.01.
Please address correspondence and reprint requests to: Dr. Adel M. Al-Awadhi, Department of Medicine, Faculty of Medicine, Kuwait University, P.O. Box 24923, Al-Safat 13110, Kuwait.
E-mail: adelalawadhi@yahoo.com