Departments of Family and Community Medicine, Public Health Sciences, and Anesthesiology and Perioperative Medicine, Pennsylvania State University College of Medicine, Hershey, PA.
University of Wisconsin-Madison, School of Medicine and Public Health, Department of Family Medicine and Community Health, Madison, WI.
Medicine (Baltimore). 2023 Oct 13;102(41):e34885. doi: 10.1097/MD.0000000000034885.
This study aimed to evaluate the impact of the COVID-19 pandemic on adults with opioid-treated chronic low back pain (CLBP), an understudied area. Participants in a "parent" clinical trial of non-pharmacologic treatments for CLBP were invited to complete a one-time survey on the perceived pandemic impact across several CLBP- and opioid therapy-related domains. Participant clinical and other characteristics were derived from the parent study's data. Descriptive statistics and latent class analysis analyzed quantitative data; qualitative thematic analysis was applied to qualitative data. The survey was completed by 480 respondents from June 2020 to August 2021. The majority reported a negative pandemic impact on their life (84.8%), with worsened enjoyment of life (74.6%), mental health (74.4%), pain (53.8%), pain-coping skills (49.7%), and finances (45.3%). One-fifth (19.4%) of respondents noted increased use of prescribed opioids; at the same time, decreased access to medication and overall healthcare was reported by 11.3% and 61.6% of respondents, respectively. Latent class analysis of the COVID-19 survey responses revealed 2 patterns of pandemic-related impact; those with worse pandemic-associated harms (n = 106) had an overall worse health profile compared to those with a lesser pandemic impact. The pandemic substantially affected all domains of relevant health-related outcomes as well as healthcare access, general wellbeing, and financial stability among adults with opioid-treated CLBP. A more nuanced evaluation revealed a heterogeneity of experiences, underscoring the need for both increased overall support for this population and for an individualized approach to mitigate harms induced by pandemic or similar crises.
本研究旨在评估 COVID-19 大流行对接受阿片类药物治疗的慢性下腰痛(CLBP)成年人的影响,这是一个研究不足的领域。邀请参与 CLBP 非药物治疗“父母”临床试验的参与者完成一次关于 COVID-19 对几个 CLBP 和阿片类药物治疗相关领域感知影响的调查。参与者的临床和其他特征来自父母研究的数据。描述性统计和潜在类别分析用于分析定量数据;定性主题分析用于分析定性数据。该调查于 2020 年 6 月至 2021 年 8 月期间完成,共收到 480 名受访者的回复。大多数受访者报告 COVID-19 对其生活产生负面影响(84.8%),生活享受度恶化(74.6%)、心理健康恶化(74.4%)、疼痛恶化(53.8%)、疼痛应对技能恶化(49.7%)和财务恶化(45.3%)。五分之一(19.4%)的受访者指出增加了处方阿片类药物的使用;与此同时,11.3%和 61.6%的受访者分别报告称,他们获得药物和整体医疗保健的机会减少。COVID-19 调查回复的潜在类别分析揭示了 2 种与大流行相关影响模式;那些与大流行相关危害更大的(n=106)与那些大流行影响较小的相比,整体健康状况更差。大流行严重影响了接受阿片类药物治疗的慢性下腰痛成年人的相关健康相关结果的所有领域,以及医疗保健获取、整体幸福感和财务稳定。更细致的评估显示出经验的异质性,强调需要增加对这一人群的全面支持,并采取个性化方法来减轻大流行或类似危机引起的危害。