Chronic Back and Neck Pain: Care Seeking and Evidence

慢性背部和颈部疼痛：寻求护理和证据

• 批准号: 7125490
• 负责人: TIMOTHY S CAREY
• 金额: $ 31.37万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-09-20 至 2008-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7125490
• 关键词: backache; behavioral /social science research tag; chronic pain; clinical research; combination therapy; health care cost /financing; health care service evaluation; health care service utilization; health services research tag; health surveys; human subject; human therapy evaluation; interview; longitudinal human study; lumbosacral region; musculoskeletal disorder therapy; neck; patient care; patient oriented research

DESCRIPTION (provided by applicant): Chronic low back and neck pain associated with functional incapacity are common and costly conditions affecting at least 4-5% of the population. They are associated with a large burden of suffering, as well as health care and social costs of over $50 billion per year. New technology and the growth of specialty practices such as spine and pain clinics have led to patients using combinations of providers, diagnostic tests and therapeutic modalities. Research including randomized trials and systematic reviews have provided a substantial evidence base regarding the effectiveness of specific single treatments, but information on combinations of treatments is lacking. Building on surveys conducted in North Carolina (NC) a decade ago, we propose to conduct a population- based telephone survey to examine the prevalence of and care used for chronic back and neck pain. Our specific aims are to: 1 .Describe the prevalence of chronic low back and neck pain in NC and the demographic and clinical characteristics of these individuals. 2. Describe the care seeking patterns among this population. 3. Identify demographic and clincial factors associated with the more common provider and provider-treatment combinations. 4. Compare commonly used treatments and combinations of treatments with current evidence of therapeutic effectiveness. We will conduct a survey of 6,000 randomly selected NC households addressing the prevalence of chronic back and neck pain, global and condition-specific functioning, depression, care utilization and satisfaction with care, as well as other factors. We anticipate that this survey will identify over 400 patients with chronic pain. We will examine the combinations of care used in descriptive analyses, factor analysis, logistic regression analysis and cluster analysis. We hypothesize that care seeking will have increased compared with the 1990's, with greater use of technology and multiple provider use. Using the techniques of evidence-based medicine, we will then examine the evidence for the most common treatments and combinations, identifying common treatments that are not based on evidence, setting the stage for future randomized trials or modifications in practice patterns.

描述（由申请人提供）：与功能丧失能力相关的慢性低背和颈部疼痛是普遍且昂贵的条件，影响至少4-5％的人口。它们与每年超过500亿美元的医疗保健和社会成本相关。新技术以及诸如脊柱和疼痛诊所等专业实践的增长使患者使用了提供者的组合，诊断测试和治疗方式。包括随机试验和系统评价在内的研究为特定单一治疗的有效性提供了大量证据，但缺乏有关治疗组合的信息。 在十年前在北卡罗来纳州（NC）进行的调查的基础上，我们建议进行基于人群的电话调查，以检查用于慢性背部和颈部疼痛的患病率和护理。我们的具体目的是：1。描述NC中慢性低背和颈部疼痛的患病率以及这些人的人口统计和临床特征。 2。描述这一人群中寻求护理模式。 3。确定与更常见的提供商和提供商治疗组合相关的人口统计学和周围因素。 4。将常用的治疗方法和治疗的组合与当前的治疗有效性证据进行比较。我们将对6,000个随机选择的NC家庭进行调查，以解决慢性背部疼痛，全球和条件特异性功能，抑郁，护理利用和对护理的满意度以及其他因素的患病率。我们预计这项调查将确定400多名慢性疼痛患者。我们将研究描述性分析，因子分析，逻辑回归分析和聚类分析中使用的护理的组合。我们假设与1990年代相比，随着技术和多个提供商的使用，寻求护理将有所增加。然后，我们将使用基于循证医学的技术研究最常见的治疗方法和组合的证据，确定不基于证据的常见治疗方法，为未来的随机试验或实践模式中的修改奠定了阶段。