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AHRQ Research Studies Date
Topics
- (-) Back Health and Pain (10)
- Chronic Conditions (1)
- Comparative Effectiveness (1)
- Elderly (4)
- Emergency Department (1)
- Evidence-Based Practice (1)
- Healthcare Costs (1)
- Healthcare Utilization (3)
- Imaging (1)
- Opioids (1)
- Outcomes (1)
- Pain (5)
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- Racial and Ethnic Minorities (1)
- Rehabilitation (1)
- Social Determinants of Health (1)
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 10 of 10 Research Studies DisplayedJackson P, Goodin BR, Long DL
The area deprivation index corresponds effectively with other measures of objective socioeconomic status in adults with chronic low back pain.
The purpose of this study was to compare the Area Deprivation Index (ADI) and other measures of socioeconomic status (SES), including income, education, and subjective social status (SSS), in their ability to predict pain severity/ interference in patients with chronic low back pain. The study found that pain severity/ interference correlated negatively with income and education and correlated positively with ADI. Criterion scores of the pain severity model indicate income performs best followed by ADI, with similar results with the pain interference model. The study concluded that when attempting to understand the impact of SES on chronic low back pain, neighborhood-level and individual-level factors should be considered.
AHRQ-funded; HS013852.
Citation: Jackson P, Goodin BR, Long DL .
The area deprivation index corresponds effectively with other measures of objective socioeconomic status in adults with chronic low back pain.
J Nurs Meas 2022 Sep 1;30(3):433-48. doi: 10.1891/jnm-d-20-00126..
Keywords: Back Health and Pain, Pain, Chronic Conditions, Social Determinants of Health
Curatolo M, Rundell SD, Gold LS
Long-term effectiveness of epidural steroid injections after new episodes of low back pain in older adults.
The purpose of this prospective study was to compare older adults undergoing epidural steroid injections (ESI) with patients not receiving ESI to test the hypotheses that those on ESI: 1) have worse outcomes before ESI, 2) have improved outcomes after ESI, and 3) have improved outcomes due to a specific ESI effect. The researchers evaluated patients 65 years of age or older from 3 United States health care systems who presented to primary care with new episodes of back pain. The three outcomes assessed were back and leg pain intensity, disability, and quality of life, all of which were evaluated at baseline, and then with 3-, 6-, 12- and 24- month follow-ups. The study found that in ESI patients, pain intensity, disability, and quality of life at baseline were significantly worse than in non-ESI patients. The study concluded that adults 65 and older who were treated with ESI have long-term improvement, but the improvement is not likely to be related to a specific effect of ESI, making epidural steroid injections unlikely to provide long-term benefits.
AHRQ-funded; HS019222; HS022972.
Citation: Curatolo M, Rundell SD, Gold LS .
Long-term effectiveness of epidural steroid injections after new episodes of low back pain in older adults.
Eur J Pain 2022 Aug;26(7):1469-80. doi: 10.1002/ejp.1975..
Keywords: Elderly, Back Health and Pain, Pain, Treatments
Sisco-Taylor BL, Magel JS, McFadden M
Changes in pain catastrophizing and fear-avoidance beliefs as mediators of early physical therapy on disability and pain in acute low-back pain: a secondary analysis of a clinical trial.
In this study, the researchers hypothesized that reducing pain catastrophizing and fear-avoidance beliefs early would mediate early physical therapy’s effects on changes in disability and pain intensity. The Fear-Avoidance Model (FAM) postulates that pain catastrophizing and fear-avoidance beliefs are predictive for chronicity and disability. The research studied 204 clinical study trial patients who had been experiencing low-back pain for less than 16 days. At a baseline, 4 weeks, 3 months, and 1 year, the participants completed the Pain Catastrophizing Scale (PCS), Fear-Avoidance Beliefs Questionnaire (FABQ work and physical activity scales), and outcomes (Oswestry Disability Index and Numeric Pain Rating Scale). The researchers found that early physical therapy led to improvements in pain and disability over 3 months, but not 1 year. In the single mediator model, 4-week reductions in pain catastrophizing mediated the effects of early PT on 3-month disability and pain intensity improvements, but the effects were small. The study concluded that at least partly through reducing patients’ catastrophizing, early physical therapy may improve disability and pain outcomes in patients with acute low-back pain.
AHRQ-funded; HS018672.
Citation: Sisco-Taylor BL, Magel JS, McFadden M .
Changes in pain catastrophizing and fear-avoidance beliefs as mediators of early physical therapy on disability and pain in acute low-back pain: a secondary analysis of a clinical trial.
Pain Med 2022 May 30;23(6):1127-37. doi: 10.1093/pm/pnab292..
Keywords: Back Health and Pain, Pain
Kim HS, Muschong KM, Fishman IL KM, Fishman IL
Embedded emergency department physical therapy versus usual care for acute low back pain: a protocol for the NEED-PT randomised trial.
This protocol paper discusses a study that will evaluate outcomes of having an embedded physical therapist in the emergency department (ED) for patients experiencing acute low back pain. The desired outcome is lower patient-reported opioid use post-discharge. The study will enroll patients with acute low back pain at an urban academic ED in Chicago, Illinois. This case-control study will randomize patients to either the embedded physical therapy or the usual care. The authors will follow the patients to a primary endpoint of 3 months and compare a primary outcome of change in PROMIS-Pain Interference score and secondary outcomes of change in modified Oswestry Disability Index score and patient-reported opioid use.
AHRQ-funded; HS027426.
Citation: Kim HS, Muschong KM, Fishman IL KM, Fishman IL .
Embedded emergency department physical therapy versus usual care for acute low back pain: a protocol for the NEED-PT randomised trial.
BMJ Open 2022 May 24;12(5):e061283. doi: 10.1136/bmjopen-2022-061283..
Keywords: Emergency Department, Back Health and Pain, Pain
Jarvik JG, Gold LS, Tan K
Long-term outcomes of a large, prospective observational cohort of older adults with back pain.
The study’s primary goals were to report 2-year outcomes of older adults initiating primary care for back pain and to examine the relative importance of patient factors vs. medical interventions in predicting 2-year disability and pain. The investigators found that baseline patient factors were more important than early interventions in explaining disability and pain after 2 years.
AHRQ-funded; HS019222; HS022972.
Citation: Jarvik JG, Gold LS, Tan K .
Long-term outcomes of a large, prospective observational cohort of older adults with back pain.
Spine J 2018 Jan 29;18(9):1540-51. doi: 10.1016/j.spinee.2018.01.018..
Keywords: Back Health and Pain, Elderly, Patient-Centered Outcomes Research
Milani CJ, Rundell SD, Jarvik JG
Associations of race and ethnicity with patient-reported outcomes and health care utilization among older adults initiating a new episode of care for back pain.
The purpose of this study was to characterize associations of self-reported race/ethnicity with back pain (BP) patient-reported outcomes and health care utilization among older adults with a new episode of care for BP. The investigators found that Blacks and Hispanics had slightly less improvement in BP-related functional limitations over time, and less spine-related health care utilization, as compared to whites and non-Hispanics, respectively. The authors suggested that residual confounding may explain some of the association between race/ethnicity and health outcomes.
AHRQ-funded; HS019222; HS022972.
Citation: Milani CJ, Rundell SD, Jarvik JG .
Associations of race and ethnicity with patient-reported outcomes and health care utilization among older adults initiating a new episode of care for back pain.
Spine 2018 Jul 15;43(14):1007-17. doi: 10.1097/brs.0000000000002499..
Keywords: Back Health and Pain, Elderly, Healthcare Utilization, Outcomes, Racial and Ethnic Minorities
Graves JM, Fulton-Kehoe D, Jarvik JG
Impact of an advanced imaging utilization review program on downstream health care utilization and costs for low back pain.
Investigators researched the impact of imaging tests such as magnetic resonance imaging (MRI) for lower back pain (LBP) on utilization and duration of workers’ compensation claims. Claims from 76,119 Washington State workers with LBP from 2006 to 2014 were used to see if a policy that implemented prospective utilization review (UR) for early MRI increased costs per claim, disability duration and the proportion of workers who received benefits. Results showed there were noticeable effects from MRI tests, but not computed tomography or surgery utilization.
AHRQ-funded; HS019222.
Citation: Graves JM, Fulton-Kehoe D, Jarvik JG .
Impact of an advanced imaging utilization review program on downstream health care utilization and costs for low back pain.
Med Care 2018 Jun;56(6):520-28. doi: 10.1097/mlr.0000000000000917..
Keywords: Back Health and Pain, Healthcare Utilization, Imaging, Pain
Gold LS, Hansen RN, Avins AL
Associations of early opioid use with patient-reported outcomes and health care utilization among older adults with low back pain.
The objective of this study was to compare outcomes and health care utilization of older patients who did versus did not fill opioid prescriptions within 90 days of initiating care for low back pain. Among older patients with new back pain visits, filling 2 or more opioid prescriptions within 90 days of the visit was associated with similar back pain-related outcomes but increased likelihood of filling opioid prescriptions 18 to 24 months later compared with matched patients who did not fill early opioid prescriptions.
AHRQ-funded; HS019222; HS022972.
Citation: Gold LS, Hansen RN, Avins AL .
Associations of early opioid use with patient-reported outcomes and health care utilization among older adults with low back pain.
Clin J Pain 2018 Apr;34(4):297-305. doi: 10.1097/ajp.0000000000000557.
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Keywords: Back Health and Pain, Elderly, Healthcare Utilization, Patient-Centered Outcomes Research, Opioids
Tapp SJ, Martin BI, Tosteson TD
Understanding the value of minimally invasive procedures for the treatment of lumbar spinal stenosis: the case of interspinous spacer devices.
Minimally invasive lumbar spinal stenosis procedures have uncertain long-term value. This study sought to characterize factors affecting the long-term cost-effectiveness of such procedures using interspinous spacer devices ("spacers") relative to decompression surgery as a case study.
AHRQ-funded; HS018405.
Citation: Tapp SJ, Martin BI, Tosteson TD .
Understanding the value of minimally invasive procedures for the treatment of lumbar spinal stenosis: the case of interspinous spacer devices.
Spine J 2018 Apr;18(4):584-92. doi: 10.1016/j.spinee.2017.08.246..
Keywords: Back Health and Pain, Healthcare Costs, Healthcare Costs, Surgery
Skolasky RL, Maggard AM, Wegener ST
Telephone-based intervention to improve rehabilitation engagement after spinal stenosis surgery: a prospective lagged controlled trial.
A prospective interventional trial was conducted, to compare the effectiveness of health behavior change counseling with usual care to improve health outcomes after lumbar spine surgical procedures. The investigators found that health behavior change counseling improved health outcomes during the first 12 months after the surgical procedure through changes in rehabilitation engagement.
AHRQ-funded; HS017990.
Citation: Skolasky RL, Maggard AM, Wegener ST .
Telephone-based intervention to improve rehabilitation engagement after spinal stenosis surgery: a prospective lagged controlled trial.
J Bone Joint Surg Am 2018 Jan 3;100(1):21-30. doi: 10.2106/jbjs.17.00418..
Keywords: Back Health and Pain, Comparative Effectiveness, Evidence-Based Practice, Patient-Centered Outcomes Research, Rehabilitation, Surgery