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Search All Research Studies
AHRQ Research Studies Date
Topics
- (-) Back Health and Pain (9)
- Comparative Effectiveness (1)
- Elderly (3)
- Emergency Department (1)
- Evidence-Based Practice (1)
- Healthcare Costs (2)
- Healthcare Utilization (3)
- Imaging (2)
- Opioids (1)
- Orthopedics (1)
- Outcomes (1)
- Pain (4)
- Patient-Centered Outcomes Research (3)
- Patient Experience (1)
- Racial and Ethnic Minorities (1)
- Rehabilitation (1)
- Surgery (3)
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 9 of 9 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
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