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: 7280964
• 负责人: TIMOTHY S CAREY
• 金额: $ 15.23万
• 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/7280964
• 关键词: Acupuncture procedure; Address; Affect; Back; Caring; Characteristics; Chronic; Chronic low back pain; Chronic neck pain; Clinic; Clinical; Cluster Analysis; Condition; Data; Diagnostic tests; Effectiveness; Evidence Based Medicine; Exercise; Factor Analysis; Future; Growth; Health Care Costs; Health Personnel; Healthcare; Household; Individual; Injection of therapeutic agent; Invasive; Logistics; Longevity; Low Back Pain; Manipulative Therapies; Mental Depression; Modality; Modification; Neck Pain; North Carolina; Operative Surgical Procedures; Pain Clinics; Patients; Pattern; Pharmaceutical Preparations; Population; Prevalence; Procedures; Provider; Randomized Controlled Clinical Trials; Range; Recording of previous events; Regression Analysis; Research; Research Personnel; Review, Systematic (PT); Sampling; Spinal; Staging; Surveys; Symptoms; Techniques; Technology; Telephone; Testing; Therapeutic; Time; Vertebral column; Work; base; care seeking; chronic pain; cost; disability; medical specialties; multidisciplinary; new technology; outcome forecast; programs; satisfaction; social; therapeutic effectiveness

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）：与功能丧失相关的慢性下背部和颈部疼痛是常见且昂贵的疾病，影响至少4 - 5%的人群。它们造成巨大的痛苦负担，每年造成超过500亿美元的保健和社会费用。新技术和脊柱和疼痛诊所等专业实践的发展导致患者使用提供者，诊断测试和治疗方式的组合。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基础，但缺乏联合治疗的信息。 基于十年前在北卡罗来纳州（NC）进行的调查，我们建议进行一项基于人口的电话调查，以检查慢性背部和颈部疼痛的患病率和治疗情况。我们的具体目标是：1.描述NC中慢性腰痛和颈痛的患病率以及这些个体的人口统计学和临床特征。2.描述这一人群的求医模式。3.确定与更常见的提供者和提供者治疗组合相关的人口统计学和临床因素。4.将常用的治疗方法和治疗组合与当前的治疗有效性证据进行比较。我们将对随机选择的6，000个NC家庭进行调查，以解决慢性背部和颈部疼痛的患病率，全球和特定条件的功能，抑郁症，护理利用和护理满意度以及其他因素。我们预计这项调查将确定400多名慢性疼痛患者。我们将研究组合的护理中使用的描述性分析，因素分析，逻辑回归分析和聚类分析。我们假设，随着技术的更多使用和多个提供者的使用，与20世纪90年代相比，寻求护理的情况将会增加。使用循证医学的技术，我们将检查最常见的治疗和组合的证据，确定不基于证据的常见治疗，为未来的随机试验或实践模式的修改奠定基础。