Exposure to guideline nonconcordant care facilitated transition to chronic low back pain
According to published results, U.S. patients with early exposure to guideline nonconcordant treatment exhibited a substantial transition from acute to chronic low back.
From May 2016 to March 2020, researchers analyzed 5,233 adult patients with acute low back pain (LBP) who were enrolled in 77 primary care practices across the United States.
To determine whether early guideline nonconcordant processes of care (including prescribed opioids, imaging and referral to a subspecialist) were associated with the transition from acute to chronic LBP, researchers stratified patients using the subgroups for targeted treatment back tool (SBT), as well as demographic, clinical and practice characteristics.
According to the study, the overall transition rate to chronic LBP was 32% (n= 1,666 patients). After multivariate analysis, researchers found a positive association between SBT risk strata and transition to chronic LBP. Other patient and clinical characteristics associated with the transition to chronic LBP included obesity, smoking, severe baseline disability, depression and anxiety, the researchers noted.
Ultimately, researchers found that “after controlling for all other variables, patients exposed to one, two or three nonconcordant processes of care within the first 21 days were 1.39, 1.88 and 2.16 times more likely to develop chronic LBP compared with those with no exposure,” the researchers wrote in the study. “These findings suggest that an emphasis should be placed on discovering strategies to successfully implement guideline concordant care in the primary care setting to reduce the development of chronic LBP,” they concluded.
Collapse
Read more about