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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 3 of 3 Research Studies DisplayedKim HS, Strickland KJ, Seitz AL
Patient perspectives on seeking emergency care for acute low back pain and access to physical therapy in the emergency department.
This study’s purpose was to explore patient perspectives on visiting the emergency department (ED) for low back pain to inform a more patient-centered approach to emergency care. The authors conducted focus group discussions and individual interviews among patients visiting an urban academic ED for acute low back pain. They recruited participants from an ongoing prospective study of 101 patients receiving either ED-initiated physical therapy or usual care. They conducted 4 focus group discussions among 18 participants (median age 46.5 years, 66.7% women, 61.1% Black) and individual interviews with 27 participants (median age 45 years, 55.6% women, 44.4% White). They identified 5 summary themes: (1) the decision to seek emergency care for low back pain is motivated by severe pain, resulting disability, and fears about a catastrophic diagnosis, (2) participants sought various goals from their ED visit but emphasized the primacy of pain control, (3) participants were reluctant to use pain medications but also acknowledged their benefit, (4) participants perceived a number of benefits from direct access to an ED physical therapist in the ED, and (5) participation in physical therapy ultimately facilitated recovery, but the pain was a barrier to performing exercises.
AHRQ-funded; HS023011; HS027426.
Citation: Kim HS, Strickland KJ, Seitz AL .
Patient perspectives on seeking emergency care for acute low back pain and access to physical therapy in the emergency department.
Ann Emerg Med 2023 Aug; 82(2):154-63. doi: 10.1016/j.annemergmed.2022.12.028..
Keywords: Emergency Department, Back Health and Pain, Pain
Ayers DC, Zheng H, Yang W
How back pain affects patient satisfaction after primary total knee arthroplasty.
This study looked at patient-reported outcomes (PROs) for patients with back pain (BP) who underwent total knee arthroscopy (TKA) surgery for pre- and postoperatively. This multicenter cohort study included 9,057 patients undergoing primary unilateral TKA who were enrolled in FORCE-TJ. Back pain (BP) intensity was assessed using the Oswestry back disability index (ODI) pain intensity questionnaire, with BP severity then classified into 4 categories. PROs were collected preoperatively and postoperatively after 1 year including the Knee injury and Osteoarthritis Outcome Score (KOOS) (total score, pain, Activities of Daily Living (ADL), and Quality of Life (QOL), Short-Form health survey 36-item (SF-36) Physical Component Score (PCS), and Mental Component Score (MCS)). At 1 year a total of 18.3% TKA patients were dissatisfied. At the time of surgery, a total of 4,765 patients (52.6%) reported back pain, divided into mild BP (24.9%), moderate (20.3%), and severe (7.2%). Severe back pain was significantly associated with patient dissatisfaction at 1 year after TKA. The predictive variables for dissatisfaction include age [odds ratio (OR) for younger patients <65 years versus older patients ≥65 years], educational level [OR for post high school versus less], smoking [OR for nonsmoker versus current smoker)], and Charlson comorbidity index [OR for CCI ≥2 versus 0]. The authors recommend surgeons consider a spine evaluation in patients who have severe BP prior to TKA.
AHRQ-funded; HS018910.
Citation: Ayers DC, Zheng H, Yang W .
How back pain affects patient satisfaction after primary total knee arthroplasty.
J Arthroplasty 2023 Jun; 38(6s):S103-s08. doi: 10.1016/j.arth.2023.03.072..
Keywords: Back Health and Pain, Pain, Pain, Patient Experience, Orthopedics, Surgery
Ganguli I, Ying W, Shakley T
Cascade services and spending following low-value imaging for uncomplicated low back pain among commercially insured adults.
The purpose of this study was to examine the impact of low-value imaging on cascade services and spending in commercially-insured adults with uncomplicated acute low back pain. The researchers analyzed medical claims from Blue Cross Blue Shield of Massachusetts members aged 18-50 years who received a 2018 diagnosis of uncomplicated low back pain, for which imaging was considered inappropriate according to the National Committee for Quality Assurance Healthcare Effectiveness Data and Information Set (HEDIS) criteria. In 2018, 30,892 members were eligible for low-value imaging. Of these, 6009 (19.5%) received low-value imaging: 5091 (16.5%) X-ray and 787 (2.5%) MRI. The study found that when compared to patients without low-value imaging, those with low-value X-ray or MRI had higher adjusted probabilities of receiving cascade services and greater adjusted total spending at 3, 6, and 12 months. These results were robust to falsification testing. Members with high deductible health plans (HDHP) had higher narrowly defined cascade-associated out-of-pocket spending than those in other plans. The most common sources of narrowly defined cascade-associated spending were physical therapy, office visits, radiology studies, laboratory studies, and surgery.
J Gen Intern Med 2023 Mar;38(4):1102-05. doi: 10.1007/s11606-022-07829-2
Citation: Ganguli I, Ying W, Shakley T .
Cascade services and spending following low-value imaging for uncomplicated low back pain among commercially insured adults.
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Keywords: Imaging, Back Health and Pain, Pain, Healthcare Costs