Demographic Characteristics Associated With Utilization of Noninvasive Treatments for Chronic Low Back Pain and Related Clinical Outcomes During the COVID-19 Pandemic in the United States
Demographic Characteristics Associated With Utilization of Noninvasive Treatments for Chronic Low Back Pain and Related Clinical Outcomes During the COVID-19 Pandemic in the United States
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DOI：
10.3122/jabfm.2021.s1.200352
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发表时间：
2021-02-01
影响因子：
2.9
通讯作者：
Licciardone, John C.
中科院分区：
文献类型：
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作者：
Licciardone, John C.
本研究旨在确定COVID-19大流行期间有限的医疗保健机会是否影响慢性腰痛患者推荐的非药物治疗、非甾体抗炎药和阿片类药物的使用，并影响与疼痛强度和残疾相关的临床结果。方法：在流行病学、临床和介入性研究和创新疼痛登记处的参与者，如果他们在国家紧急宣布日期（NEPD）之前和之后的3个月内提供遭遇数据，则符合条件。结果：528名研究参与者的平均年龄为53.9岁，其中74.1%为女性。大流行期间，运动疗法、按摩疗法和脊柱推拿的使用率有所下降。年龄的增长与除运动疗法外的所有非药物治疗的使用率下降以及大流行期间阿片类药物使用的增加有关。非裔美国人参与者报告说，在大流行期间，瑜伽和脊柱推拿的使用率有所下降。总体而言，NEPD前后疼痛强度和残疾的平均变化评分无显著性差异。然而，非裔美国人参与者在大流行期间一致报告了更严重的疼痛强度和残疾结果。在女性中，随着年龄和残疾的增加，疼痛强度的一致性较差。讨论：大流行期间的社交距离影响了慢性腰痛推荐的非药物治疗的采用，这些治疗需要访问社区设施或与提供者密切互动。结论：大流行有可能加剧慢性腰痛的影响，特别是在非洲裔美国患者和老年人群中，因为它阻碍了获得指南规定的非侵入性治疗。
Introduction: This study was conducted to determine if limited access to health care during the COVID-19 pandemic impacted utilization of recommended nonpharmacological treatments, nonsteroidal anti-inflammatory drugs, and opioids by patients with chronic low back pain and affected clinical outcomes relating to pain intensity and disability.Methods: Participants within the Pain Registry for Epidemiological, Clinical, and Interventional Studies and Innovation were eligible if they provided encounter data in the 3 months immediately before and after the national emergency proclamation date (NEPD).Results: The mean age of the 528 study participants was 53.9 years and 74.1% were women. Utilization of exercise therapy, massage therapy, and spinal manipulation decreased during the pandemic. Increasing age was associated with decreased utilization of all nonpharmacological treatments except exercise therapy, and with increased opioid use during the pandemic. African American participants reported decreased utilization of yoga and spinal manipulation during the pandemic. Overall, mean change scores for pain intensity and disability before and after the NEPD were not significant. However, African American participants consistently reported worse pain intensity and disability outcomes during the pandemic. Marginally worse outcomes were observed less consistently for pain intensity with increasing age and for disability among women.Discussion: Social distancing during the pandemic impacted the uptake of recommended nonpharmacological treatments for chronic low back pain that require visiting community-based facilities or interacting closely with providers.Conclusions: The pandemic threatens to exacerbate the impact of chronic low back pain, particularly among African American patients and the older population, by impeding access to guideline-informed noninvasive treatments.