Is there a gender bias in recommendations for further rehabilitation in primary care of patients with chronic pain after an interdisciplinary team assessment?

This study sough to investigate potential gender bias in recommendations of further examination and rehabilitation in primary care for patients with chronic musculoskeletal pain following an interdisciplinary team assessment. The population was comprised of consecutive patients (n = 589 women, 262 men) referred during a 3-year period from primary healthcare for assessment by interdisciplinary teams at a pain specialist rehabilitation clinic. Patient data were collected from the Swedish Quality Registry for Pain Rehabilitation. The outcome was defined as the examination or rehabilitation that was specified in the patient’s record. Men had a significantly greater likelihood than women of being recommended physiotherapy and radiological examination, and the gender difference was not explained by confounding variables and covariates (age, marital status, ethnicity, education, working status, pain severity, pain interference, pain sites, anxiety and depression). There weren’t any significant gender differences in recommendations to treatment by specialist physician, occupational therapist, psychologist or social worker.

These findings suggest that the interdisciplinary teams in specialist healthcare may discriminate against women with chronic pain when physiotherapy and radiological investigation are recommended. The team’s choice of recommendations might be affected by gendered attitudes, but this field of research needs to be studied further.