Journal of Preventive Medicine and Public Health

Original Article

Prognostic Scoring Model for the Transition From Acute to Chronic Non-specific Low Back Pain in Primary Health Care Units in Indonesia: Djoko Kuswanto, Riva Satya Radiansyah, Dwinka Syafira Eljatin, Muhammad Nazhif Haykal, Rumman Karimah, Ratri Dwi Indriani, Zain Budi Syulthoni, Erna Furaidah, Andiva Satrio Rinaldi, Hafira Nushifa Putri, Jessica Felina Adi, Anak Agung Bagus Wirayuda; J Prev Med Public Health. 2025;58(4):422-430. Published online April 12, 2025; DOI: https://doi.org/10.3961/jpmph.24.581

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Abstract Summary PDF Supplementary Material

Objectives
Non-specific low back pain (NSLBP) is a prevalent health issue that can progress from acute to chronic, resulting in prolonged disability and diminished quality of life. This study aimed to develop a prognostic scoring model to predict the transition from acute to chronic NSLBP in primary care settings.
Methods
This prospective cohort study enrolled 112 adults with acute NSLBP from primary health care units in Indonesia. Participants were assessed at baseline and at a 3-month follow-up visit. Bivariate and multivariable analyses were conducted to identify significant predictors of chronicity. A scoring system was then developed based on the final logistic regression model.
Results
Three factors were found to be significant predictors of the transition to chronic NSLBP: age above 30 years, low education level, and moderate to severe pain intensity. The prognostic scoring model demonstrated good discrimination, with an area under the receiver operating characteristic curve of 0.705, 70.8% sensitivity, and 62.5% specificity at the optimal cut-off score of 2.5.
Conclusions
This simple prognostic scoring model can help clinicians identify patients at high-risk of developing chronic NSLBP. Early identification of at-risk patients could guide targeted interventions to prevent chronicity. Further validation in diverse populations is necessary to confirm the broader applicability of this model.

Summary

Key Message
This prospective cohort study developed a prognostic scoring model to predict the transition from acute to chronic non-specific low back pain (NSLBP) in primary care settings in Indonesia. The study identified three significant predictors: age above 30 years, low education level, and moderate to severe pain intensity, which formed a simple scoring system with good discrimination ability (AUC = 0.705, sensitivity 70.8%, specificity 62.5%). This practical tool enables clinicians to identify high-risk patients early and implement targeted interventions to prevent chronicity in primary healthcare settings.

Citations

Citations to this article as recorded by

The Role of Dexketoprofen/Tramadol in Multimodal Therapy to Prevent Acute Postsurgical and Acute Low Back Pain from Developing into Chronic Pain: A Delphi Consensus Study
Giustino Varrassi, Maria Dolma Gudez-Santos, Magdi Hanna, Magdalena Kocot-Kępska, Antonio Montero Matamala, Marco Antonio Narvaez Tamayo, Serge Perrot, Jose Luis Aguilar, Omar Al Hamad, Lu’i Al-Husinat, Raad Al-Khafaji, Abdallah Allam, Ezio Amorizzo, Nadi
Pain and Therapy.2025;[Epub] CrossRef

Scoping Review

Is Farming a Risk Occupation for Cardio-cerebrovascular Diseases? A Scoping Review on Cardio-cerebrovascular Disease Risk in Farmers: Hyeonjun Kim, Wongeon Jung, Sunjin Jung, Seunghyeon Cho, Inho Jung, Hansoo Song, Ki-Soo Park, Seong-Yong Yoon, Joo Hyun Sung, Seok-Ju Yoo, Won-Ju Park; J Prev Med Public Health. 2024;57(6):521-529. Published online August 23, 2024; DOI: https://doi.org/10.3961/jpmph.24.302

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Abstract Summary PDF Supplementary Material

Objectives
In Korea, cardio-cerebrovascular disease (CCVD) is recognized as an occupational disease when sufficient evidence of a work-related burden exists. In 2021, approximately 26.8% of the payments from occupational disease insurance under the Industrial Accident Compensation Insurance Act were allocated to CCVDs. However, due to the specific nature of insurance policies for farmers, CCVD is not acknowledged as an occupational disease in their case.
Methods
We reviewed studies on the differences in the incidence, prevalence, and mortality rates of CCVDs between farmers and the general population or other occupations and described the exposure of farmers to risk factors for CCVDs.
Results
Several studies showed that farming is a high-risk occupation for CCVDs, with the following risk factors: long working hours, night work, lack of holidays, and strenuous physical labor; physical factors (noise, cold, heat, humidity, and vibration); exposure to hazardous gases (diesel exhaust, carbon monoxide, hydrogen sulfide, carbon disulfide, nitrogen oxides, and polycyclic aromatic hydrocarbons), pesticides, and dust (particulate matter, silica, and organic dust); exposure to a hypoxic environment; and job-related stress. Social isolation and lack of accessible medical facilities also function as additional risk factors by preventing farmers from receiving early interventions.
Conclusions
Farmers are exposed to various risk factors for CCVDs and are an occupation at risk for CCVDs. More studies are needed in the future to elucidate this relationship. This study lays the groundwork for future research to develop guidelines for approving CCVDs as occupational diseases among farmers.

Summary

Korean summary
이 연구는 농업이 뇌심혈관질환과 연관된 고위험 직업임을 입증하는 근거를 검토하였습니다. 농업인은 긴 근무 시간, 격렬한 신체 노동, 유해 가스 및 살충제 노출 등 다양한 위험 요인과 더불어 의료 접근성 부족과 같은 문제에 직면해 있습니다. 이는 뇌심혈관질환을 농업인의 업무 관련 질병으로 인정하기 위한 가이드라인 개발에 중요한 기초를 제공합니다.

Key Message
This study reviewed evidence supporting that farming is a high-risk occupation associated with cardio-cerebrovascular diseases. Farmers face various risk factors, including long working hours, strenuous physical labor, exposure to hazardous gases and pesticides, and challenges such as limited access to medical care. This provides an essential foundation for developing guidelines to recognize cardio-cerebrovascular diseases as work-related illnesses among farmers.

Citations

Citations to this article as recorded by

Leveraging Administrative Health Databases to Address Health Challenges in Farming Populations: Scoping Review and Bibliometric Analysis (1975-2024)
Pascal Petit, Nicolas Vuillerme
JMIR Public Health and Surveillance.2025; 11: e62939. CrossRef

Special Article

Examining the Role of Psychosocial Stressors in Hypertension: Komal Marwaha; J Prev Med Public Health. 2022;55(6):499-505. Published online November 30, 2022; DOI: https://doi.org/10.3961/jpmph.21.266

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