Utilization of pain medications and its effect on quality of life, health care utilization and associated costs in individuals with chronic back pain.
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ABSTRACT: Purpose
Pain medications are widely prescribed to treat chronic back pain (CBP). However, the effect of using pain medications on individuals with CBP has received very little attention.Objective
The aim of this study was to determine the patterns of pharmacological treatment in the population with CBP and assess its impact on quality of life, health care utilization and associated costs in USA.Patients and methods
Retrospective, cross-sectional data obtained from the Medical Expenditure Panel Survey (MEPS), from 2011 to 2015, were utilized for this study. Pharmacological treatment for CBP was categorized into three mutually exclusive categories: 1) opioids only, 2) nonsteroidal anti-inflammatory drugs (NSAIDs) only, 3) opioids and NSAIDs (combination). The effect of the use of these treatments was also evaluated.Results
A total of 5,203 individuals with CBP were identified. Of these, 2,568 (49.4%) utilized opioids only, 1,448 (27.8%) utilized NSAIDs only and 1,187 (22.8%) utilized both pain medications. Lower health-related quality-of-life scores on both the Short Form Health Survey-12 version 2 (SF-12v2) components (mental component summary score: 44.42 vs 46.67, P<0.001; physical component summary score: 35.34 vs 40.11, P<0.001) were observed for the opioid-only group compared to the NSAID-only group. In addition, individuals utilizing opioids only had greater utilization of inpatient services, office-based services, outpatient services and emergency room visits along with higher related health care costs.Conclusion
Future researchers need to investigate the long-term risks and benefits of opioids, and policy makers should evaluate the prescribing guidelines to aim for a more patient-centered care.
SUBMITTER: Desai R
PROVIDER: S-EPMC6362928 | biostudies-literature |
REPOSITORIES: biostudies-literature
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| S-EPMC4657202 | biostudies-literature
Project description:Depression is a relevant risk factor for low back pain and is associated with the outcomes of low back pain. Depression also often overlaps with somatisation. As previous studies have suggested that somatisation or a higher somatic symptom burden has a role in the outcomes of low back pain, the aim of the present cross-sectional study was to examine whether somatic symptom burden was associated with health-related quality of life in individuals with chronic low back pain independent of depression. We analyzed internet survey data on physical and mental health in Japanese adults aged 20-64 years with chronic low back pain (n = 3,100). Health-related quality of life was assessed using the EuroQol five dimensions (EQ-5D) questionnaire. Somatic symptom burden and depression were assessed using the Somatic Symptom Scale-8 (SSS-8) and the Patient Health Questionnaire-2 (PHQ-2), respectively. SSS-8 score was categorized as no to minimal (0-3), low (4-7), medium (8-11), high (12-15), and very high (16-32). The association between SSS-8 and EQ-5D was examined using linear regression models, adjusting for depression and other covariates, including age, sex, BMI, smoking, marital status, education, exercise, employment, and the number of comorbid diseases. A higher somatic symptom burden was significantly associated with a lower health-related quality of life independent of depression and the number of comorbid diseases (regression coefficient = 0.040 for SSS-8 high vs. very high and 0.218 for non to minimal vs. very high, p trend <0.0001). In conclusion, somatic symptom burden might be important for the health-related quality of life of individuals with chronic low back pain.
| S-EPMC5819824 | biostudies-literature
Project description:ObjectiveChronic low back pain represents a substantial cost to employers through benefits coverage and days missed due to incapacity. We sought to explore the effectiveness of Naturopathic care on chronic low back pain.MethodsThis study was a randomized clinical trial. We randomized 75 postal employees with low back pain of longer than six weeks duration to receive Naturopathic care (n = 39) or standardized physiotherapy (n = 36) over a period of 12 weeks. The study was conducted in clinics on-site in postal outlets. Participants in the Naturopathic care group received dietary counseling, deep breathing relaxation techniques and acupuncture. The control intervention received education and instruction on physiotherapy exercises using an approved education booklet. We measured low back pain using the Oswestry disability questionnaire as the primary outcome measure, and quality of life using the SF-36 in addition to low back range of motion, weight loss, and Body Mass Index as secondary outcomes.ResultsSixty-nine participants (92%) completed eight weeks or greater of the trial. Participants in the Naturopathic care group reported significantly lower back pain (-6.89, 95% CI. -9.23 to -3.54, p = <0.0001) as measured by the Oswestry questionnaire. Quality of life was also significantly improved in the group receiving Naturopathic care in all domains except for vitality. Differences for the aggregate physical component of the SF-36 was 8.47 (95% CI, 5.05 to 11.87, p = <0.0001) and for the aggregate mental component was 7.0 (95% CI, 2.25 to 11.75, p = 0.0045). All secondary outcomes were also significantly improved in the group receiving Naturopathic care: spinal flexion (p<0.0001), weight-loss (p = 0.0052) and Body Mass Index (-0.52, 95% CI, -0.96 to -0.08, p = 0.01).ConclusionsNaturopathic care provided significantly greater improvement than physiotherapy advice for patients with chronic low back pain.Trial registrationControlled-Trials.com ISRCTN41920953.
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