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Greater health care utilization, opioid use seen in patients with low back pain who smoke
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Patients with low back pain who smoke had higher rates of health care utilization and opioid use compared with patients who did not smoke, according to a presentation at the Association of Academic Physiatrists Annual Meeting.
“We were able to use the big data available to us at [University of Pittsburgh Medical Center] UPMC to study and compare smokers and non-smokers with LBP,” Rohit Navlani, DO, told Healio.com/Orthopedics. “Our study has revealed that this population is high risk, as noted by the increased odds of substance abuse, opioid use and psychiatric comorbidities, such as anxiety and depression. Smokers with [low back pain] LBP were found to have higher rates of emergency department utilization and lower rates of follow-up in the outpatient clinics. An interdisciplinary approach should be considered when treating these complex patients with LBP so that all potential barriers to success can be addressed using a team approach.”
Researchers performed a retrospective cohort study of 428,401 patients with low back pain. They identified 87,062 patients who smoked and 341,339 non-smokers.
Results showed patients who smoked were more likely to undergo surgery; however, they were less likely to receive an epidural steroid injection. Patients who smoked had higher rates of depression and anxiety. Investigators noted tobacco use correlated with higher rates of opioid use before diagnosis, post-diagnosis and at any point during the clinic course. Patients with a history of smoking had a greater rate emergency department use. Patients who smoked had an average 4.4 emergency department visits vs. 3.2 visits for non-smokers. Patients who smoked has less frequent follow-ups compared with non-smokers (11.9 follow-ups on average per patient compared with 14.2 follow-ups). – by Monica Jaramillo
Disclosures: The researchers report no relevant financial disclosures.
Reference:
Navlani R, et al. Analysis of health care utilization and outcomes in smokers with low back pain. Presented at: Association of Academic Physiatrists Annual Meeting; Feb. 19-23, 2019; Puerto Rico.