Palmer Center for Chiropractic Research, Palmer College of Chiropractic, Davenport, IA, USA.
RAND Center for Collaborative Research in Complementary and Integrative Health, RAND Corporation, Santa Monica, CA, USA.
J Integr Complement Med. 2024 Mar;30(3):297-305. doi: 10.1089/jicm.2023.0233. Epub 2023 Aug 30.
To evaluate the associations between baseline demographics, health conditions, pain management strategies, and health-related quality-of-life (HRQoL) measures with pain management strategies at 3-month follow-up in respondents reporting current low-back pain (LBP). Cohort study of survey data collected from adults with LBP sampled from Amazon Mechanical Turk crowdsourcing panel. Demographics, health conditions, and the Patient-Reported Outcomes Measurement Information System (PROMIS)-10 were included in the baseline survey. Respondents reporting LBP completed a more comprehensive survey inquiring about pain management strategies and several HRQoL measures. Bivariate then multivariate logistic regression estimated odds ratios (ORs) with 95% confidence intervals (CIs) for the association between baseline characteristics and pain management utilization at 3-month follow-up. Model fit statistics were evaluated to assess the predictive value. The final cohort included 717 respondents with completed surveys. The most prevalent pain management strategy at follow-up was other care ( = 474), followed by no care ( = 94), conservative care only ( = 76), medical care only ( = 51), and medical and conservative care combined ( = 22). The conservative care only group had higher (better) mental and physical health PROMIS-10 scores as opposed to the medical care only and combination care groups, which had lower (worse) physical health scores. In multivariate models, estimated ORs (95% CIs) for the association between baseline and follow-up pain management ranged from 4.6 (2.7-7.8) for conservative care only to 16.8 (6.9-40.7) for medical care only. Additional significant baseline predictors included age, income, education, workman's compensation claim, Oswestry Disability Index score, and Global Chronic Pain Scale grade. This study provides important information regarding the association between patient characteristics, HRQoL measures, and LBP-related pain management utilization.
为了评估基线人口统计学、健康状况、疼痛管理策略以及与报告当前下背痛（LBP）的受访者的疼痛管理策略相关的健康相关生活质量（HRQoL）措施之间的关联。 这是一项从亚马逊 Mechanical Turk 众包小组中抽取的患有 LBP 的成年人中收集的调查数据的队列研究。 基线调查包括人口统计学、健康状况和患者报告的结果测量信息系统（PROMIS）-10。 报告 LBP 的受访者完成了一项更全面的调查，询问了疼痛管理策略和几项 HRQoL 措施。 使用二变量和多变量逻辑回归估计了基线特征与 3 个月随访时疼痛管理利用之间的关联的优势比（OR）和 95%置信区间（CI）。 评估模型拟合统计数据以评估预测值。 最终队列包括 717 名完成调查的受访者。 随访时最常见的疼痛管理策略是其他治疗（ = 474），其次是无治疗（ = 94）、仅保守治疗（ = 76）、仅医疗保健（ = 51）和医疗和保守治疗相结合（ = 22）。 仅保守治疗组的心理健康和身体健康 PROMIS-10 评分较高（更好），而仅医疗保健和联合治疗组的身体健康评分较低（更差）。 在多变量模型中，基线与随访疼痛管理之间关联的估计 OR（95%CI）范围从仅保守治疗的 4.6（2.7-7.8）到仅医疗保健的 16.8（6.9-40.7）。 其他重要的基线预测因素包括年龄、收入、教育、工人赔偿索赔、Oswestry 残疾指数评分和全球慢性疼痛量表等级。 这项研究提供了有关患者特征、HRQoL 措施与 LBP 相关疼痛管理利用之间关联的重要信息。
