Treatment seeking behaviour in Southern Chinese people with orofacial pain

Orofacial pain is a common debilitating condition and yet many sufferers are reluctant to seek professional help. Factors that prompt treatment seeking in Chinese people are presently uncertain. Objectives: To investigate treatment seeking behaviour associated with OFP in adult Chinese people in Hong Kong and factors related to such behaviour. Methods: A cross-sectional case-control study was conducted using HKU's Family Medicine Unit as the sampling frame. The study involved 400 participants (aged 35-70 years; 146 males/254 females) of whom 200 reported OFP. Standard questions were asked about OFP symptoms and characteristics in the previous month, the OHIP-14, GHQ-12, RDC/TMD depression/NPS scales, sleep and illness behaviour measures, and questions on pain-disability, professional treatment seeking, pain medication usage and dental attendance were administered prior to a standard clinical assessment. Multiple logistic regression using a forward stepwise model that incorporated 33 variables was used to identify independent factors related to treatment seeking. Results: 27% with OFP had sought professional advice. The majority had consulted a medical doctor (66.7%) or dentist (40.7%), 16.7% had consulted a traditional Chinese medicine (TCM) practitioner, and the majority (60%) had taken pain medication. Multiple pain symptoms (OR, 4.71; 95% C.I., 1.85-12.00) and increased duration of pain episodes (OR, 6.20; 95% C.I., 2.02-19.00) were closely associated with treatment seeking. Those who used TCM when ill (OR, 4.46; 95% C.I., 1.93-10.32) and regular dental attenders (OR, 6.48; 95% C.I., 2.26-18.61) were more likely to seek treatment. General hypochondiasis (OR, 7.76; 95% C.I. 1.41-42.61) was also closely associated with treatment seeking. Conclusion: Professional treatment seeking for OFP was low in this ethnic group. The main predictors of treatment seeking were specific pain characteristics, reliance on TCM when ill, a maladaptive response to illness and having a regular dental check-up. Such factors should be considered when formulating community health outreach initiatives. CRCG-HKU.