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Evaluation and Treatment Patterns of New Low Back Pain Episodes for Elderly Adults in the United States, 2011–2014

Bibliographic Data

ID9101721
AuthorsDan P Ly (0000-0001-5760-0208, Harvard University Press, corresponding author)
Year2020
Volume58
Issue2
Pages108-113
Publication date2020-02-01
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0000000000001244
PMID31934957
OpenAlexW2998928973
LanguageEN
Citations received1
References cited21

INTRODUCTION: New low back pain (LBP) is a common outpatient complaint. Little is known about how care is delivered over the course of a year to patients who develop new LBP and whether such care patterns are guideline-concordant. METHODS: This retrospective analysis included Medicare claims of 162,238 opioid-naïve beneficiaries with new LBP from January 1, 2011, through December 31, 2014. Simple rates of modality use [computed tomography and magnetic resonance imaging (advanced imaging), physical therapy (PT), opioid and nonopioid medications] and percentiles (5th percentile, 25th percentile, median, 75th percentile, and 95th percentile) were reported. RESULTS: Within the first year, 29.4% [95% confidence interval (CI), 29.1-29.8] of patients with ≥2 visits for new LBP received advanced imaging, and 48.4% (95% CI, 47.7-49.0) of these patients received advanced imaging within 6 weeks of the first visit; 17.3% (95% CI, 17.1-17.6) of patients with ≥2 visits received PT; 42.2% (95% CI, 41.8-42.5) of patients with ≥2 visits received non-steroidal anti-inflammatory drugs (NSAIDs), 16.9% (95% CI, 16.6-17.1) received a muscle relaxant, and 26.2% (95% CI, 25.9-26.6) received tramadol; 32.3% (95% CI, 31.9-32.6) of patients with ≥2 visits received opioids; 52.4% (95% CI, 51.7-53.0) of these patients had not received a prescription NSAID, and 82.2% (95% CI, 81.7-82.7) of these patients had not received PT. CONCLUSIONS: Many patients who develop new LBP receive guideline nonconcordant care such as early advanced imaging and opioids before other modalities like PT and prescription NSAIDs

MEDLINE · Physical therapy · Political science · Medicine · Musculoskeletal pain and rehabilitation · Opioid Use Disorder Treatment · Pain Management and Opioid Use · Gerontology

  • Association of Patient Race and Ethnicity With Differences in Opioid Prescribing by Primary Care Physicians for Older Adults With New Low Back Pain

    Open Access•Dan P Ly•JAMA Health Forum•2021

  • Comorbidity Measures for Use with Administrative Data

    Anne Elixhauser, Claudia Steiner et al.•Medical Care•1998

Citations per year0.2
Citation span2021 - 2021 (1)
Highly citedNo

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