From the University of North Texas, Health Science Center, Fort Worth, TX 76107 USA (JCL).
J Am Board Fam Med. 2021 Feb;34(Suppl):S77-S84. doi: 10.3122/jabfm.2021.S1.200352.
This study was conducted to determine if limited access to health care during the COVID-19 pandemic impacted utilization of recommended nonpharmacological treatments, nonsteroidal anti-inflammatory drugs, and opioids by patients with chronic low back pain and affected clinical outcomes relating to pain intensity and disability.
Participants within the Pain Registry for Epidemiological, Clinical, and Interventional Studies and Innovation were eligible if they provided encounter data in the 3 months immediately before and after the national emergency proclamation date (NEPD).
The mean age of the 528 study participants was 53.9 years and 74.1% were women. Utilization of exercise therapy, massage therapy, and spinal manipulation decreased during the pandemic. Increasing age was associated with decreased utilization of all nonpharmacological treatments except exercise therapy, and with increased opioid use during the pandemic. African American participants reported decreased utilization of yoga and spinal manipulation during the pandemic. Overall, mean change scores for pain intensity and disability before and after the NEPD were not significant. However, African American participants consistently reported worse pain intensity and disability outcomes during the pandemic. Marginally worse outcomes were observed less consistently for pain intensity with increasing age and for disability among women.
Social distancing during the pandemic impacted the uptake of recommended nonpharmacological treatments for chronic low back pain that require visiting community-based facilities or interacting closely with providers.
The pandemic threatens to exacerbate the impact of chronic low back pain, particularly among African American patients and the older population, by impeding access to guideline-informed noninvasive treatments.
本研究旨在确定 COVID-19 大流行期间医疗保健机会有限是否会影响慢性下背痛患者对推荐的非药物治疗、非甾体抗炎药和阿片类药物的使用，并影响与疼痛强度和残疾相关的临床结果。
如果参与者在国家紧急声明日期（NEPD）前后的 3 个月内提供了就诊数据，则有资格参与疼痛登记处的流行病学、临床和干预研究与创新。
528 名研究参与者的平均年龄为 53.9 岁，74.1%为女性。在大流行期间，运动疗法、按摩疗法和脊柱推拿的使用率下降。年龄增长与除运动疗法外的所有非药物治疗使用率降低以及大流行期间阿片类药物使用增加有关。非裔美国参与者报告说，在大流行期间瑜伽和脊柱推拿的使用率下降。总体而言，NEPD 前后疼痛强度和残疾的平均变化评分没有显著差异。然而，非裔美国参与者在大流行期间始终报告疼痛强度和残疾结果更差。随着年龄的增长，疼痛强度的结果略有恶化，而女性的残疾结果则不那么一致。
大流行期间的社交距离措施影响了需要访问社区设施或与提供者密切互动的慢性下背痛的推荐非药物治疗方法的采用。
大流行有可能通过阻碍接受循证非侵入性治疗，加剧慢性下背痛的影响，特别是对非裔美国患者和老年人群的影响。
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