Carey Timothy S, Freburger Janet K, Holmes George M, Castel Liana, Darter Jane, Agans Robert, Kalsbeek William, Jackman Anne
Cecil G. Sheps Center for Health Services Research, University of North Carolina, 725 Airport Road, Chapel Hill, NC 27599-7590, USA.
Spine (Phila Pa 1976). 2009 Apr 1;34(7):718-24. doi: 10.1097/BRS.0b013e31819792b0.
A cross-sectional, telephone survey of a representative sample of North Carolina households in 2006.
The primary objectives of these analyses were to describe health care use (providers, medications, treatments, diagnostic tests) for chronic low back pain (LBP) and relate current patterns of use to current best evidence for care of the condition.
Chronic LBP is common and expensive. Prior research on care utilization often was derived from medical claims databases, reflecting reimbursed health care use, often by one payer.
Five thousand three hundred fifty-seven households were contacted in 2006 to identify 732 noninstitutionalized adults 21 years and older with chronic LBP. Five hundred ninety individuals sought care. Patient reported health care utilization, comparison with efficacy was demonstrated by current systematic reviews.
Individuals with chronic back pain were middle-aged (mean age 53 years), and the majority were women (62%). Provider and treatment use was common and varied. Sixty percent used narcotics in the previous month. The mean number of provider visits was 21, and over one-third had an advanced imaging procedure in the past year. Physical treatments were common, and often not supported by evidence. Only 3% had engaged in a formal spine rehabilitation program. Half of patients not taking antidepressants were positive on a 2-item depression screen. Although this study was population-based, it was conducted in only one state.
Provider and treatment use for chronic LBP are both very common and varied. Current treatment patterns are consistent with overutilization of some medications and treatments, and underutilization of exercise and depression treatment.
2006年对北卡罗来纳州家庭的代表性样本进行的横断面电话调查。
这些分析的主要目的是描述慢性腰痛（LBP）的医疗保健使用情况（提供者、药物、治疗、诊断测试），并将当前的使用模式与该疾病当前的最佳护理证据相关联。
慢性腰痛很常见且费用高昂。先前关于医疗保健利用的研究通常来自医疗索赔数据库，反映的是通常由一个支付方报销的医疗保健使用情况。
2006年联系了5357户家庭，以确定732名21岁及以上患有慢性腰痛的非机构化成年人。590人寻求治疗。患者报告了医疗保健利用情况，通过当前的系统评价证明了与疗效的比较。
慢性背痛患者为中年人（平均年龄53岁），大多数为女性（62%）。提供者和治疗的使用很常见且各不相同。60%的人在上个月使用了麻醉药品。平均就诊次数为21次，超过三分之一的人在过去一年中进行了高级影像学检查。物理治疗很常见，但往往没有证据支持。只有3%的人参加了正式的脊柱康复计划。未服用抗抑郁药的患者中有一半在两项抑郁症筛查中呈阳性。尽管这项研究是以人群为基础的，但仅在一个州进行。
慢性腰痛的提供者和治疗使用既非常常见又各不相同。当前的治疗模式与某些药物和治疗的过度使用以及运动和抑郁症治疗的使用不足相一致。
