阿片类药物使用障碍对腰痛开始物理治疗的影响：一项回顾性队列研究。
The Influence of an Opioid Use Disorder on Initiating Physical Therapy for Low Back Pain: A Retrospective Cohort.
机构信息
Department of Physical Therapy and Athletic Training, University of Utah, UT (JSM, JMF, JK); Informatics, Decision-Enhancement, and Analytic Sciences Center, VA Salt Lake City Health Care System, Salt Lake City, UT; Program for Addiction Research, Clinical Care, Knowledge and Advocacy (PARCKA) and Greater Intermountain Node (GIN), Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT (AG).
出版信息
J Addict Med. 2021;15(3):226-232. doi: 10.1097/ADM.0000000000000751.
OBJECTIVES
Low back pain (LBP) is common among patients with an opioid use disorder (OUD). The extent to which patients with an OUD initiate physical therapy for LBP is unknown. The aim of this study was to examine the association between a history of an OUD and initiation of physical therapy for LBP within 60 days of a primary care provider (PCP) visit for this condition.
METHODS
Claims from a single state-wide all payer claims database from June 30, 2013 and August 31, 2015 were used to establish a retrospective cohort of patients who consulted a PCP for a new episode of LBP. The outcome measure was patients who had at least 1 physical therapy claim within 60-days after the PCP visit. After propensity score matching on covariates, logistic regression was used to compare the outcome of patients with a history of an OUD to patients without an OUD.
RESULTS
Propensity score matching resulted in 1360 matched pairs of participants. The mean age was 47.2 years (15.9) and 55.9% were female. Compared to patients without an OUD, patients with an OUD were less likely to initiate physical therapy for LBP (adjusted odds ratio = 0.65, 95% confidence intervals:0.49-0.85).
CONCLUSIONS
After a visit to a PCP for a new episode of care for LBP, patients with a history of an OUD are less likely to initiate physical therapy.
目的
患有阿片类药物使用障碍（OUD）的患者常患有下腰痛（LBP）。患有 OUD 的患者开始接受 LBP 物理治疗的程度尚不清楚。本研究旨在检查 OUD 病史与在初级保健提供者（PCP）就诊后 60 天内开始接受 LBP 物理治疗之间的关联。
方法
使用来自 2013 年 6 月 30 日至 2015 年 8 月 31 日的单一全州所有支付者索赔数据库中的索赔数据，建立了一个回顾性队列，该队列的患者因新发作 LBP 而咨询 PCP。主要结局指标是在 PCP 就诊后 60 天内至少有 1 次物理治疗索赔的患者。在对协变量进行倾向评分匹配后，使用逻辑回归比较了有 OUD 病史和无 OUD 病史的患者的结局。
结果
倾向评分匹配产生了 1360 对匹配的参与者。平均年龄为 47.2 岁（15.9），55.9%为女性。与无 OUD 的患者相比，有 OUD 的患者接受 LBP 物理治疗的可能性较小（调整后的优势比为 0.65，95%置信区间：0.49-0.85）。
结论
在 PCP 就诊后新发作 LBP 接受治疗后，有 OUD 病史的患者接受物理治疗的可能性较小。
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