Seth Watson, Elaine Trudelle-Jackson, Mark Weber, Kelli Brizzolara
{"title":"Predictors of treatment adherence in patients with centralized low back pain.","authors":"Seth Watson, Elaine Trudelle-Jackson, Mark Weber, Kelli Brizzolara","doi":"10.1177/10538127251332211","DOIUrl":null,"url":null,"abstract":"<p><p>BackgroundTreatment adherence is central to treatment success in rehabilitation for musculoskeletal conditions, including low back pain (LBP). Unfortunately, non-adherence to prescribed treatment is common and undermines treatment success.ObjectiveTo identify predictors of treatment adherence in physical therapy for patients with LBP.Methods209 cases of patients receiving physical therapy for a chief complaint of centralized LBP were retrospectively analyzed for predictors of treatment adherence. Symptom duration, pain intensity, level of disability, the presence of an opioid prescription, and patient cost were assessed as predictors of treatment adherence. Patients who completed their prescribed plan of care were classified as adherent.ResultsLogistic regression analysis revealed that individuals who had an opioid prescription were 2.56 (95% CI = 1.25-5.24, <i>p </i>= 0.010) times less likely to be adherent with treatment compared to individuals without an opioid prescription. Individuals who had symptoms for less than 1 month were 3.21 (95% CI = 1.12-9.24, <i>p </i>= 0.030) times less likely to be adherent with treatment compared to individuals who had experienced symptoms for 4 months to 1 year. Finally, individuals who paid greater than $40 per visit were 3.45 (95% CI = 1.31-9.09, <i>p </i>= 0.011) times less likely to be adherent with treatment compared to individuals who did not have to pay each visit.ConclusionThe results of this study may help clinicians quickly identify and address risk factors for lower treatment adherence in patients with LBP to mitigate the impact of suboptimal treatment adherence on patient outcomes.</p>","PeriodicalId":15129,"journal":{"name":"Journal of Back and Musculoskeletal Rehabilitation","volume":" ","pages":"10538127251332211"},"PeriodicalIF":1.4000,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Back and Musculoskeletal Rehabilitation","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/10538127251332211","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0
Abstract
BackgroundTreatment adherence is central to treatment success in rehabilitation for musculoskeletal conditions, including low back pain (LBP). Unfortunately, non-adherence to prescribed treatment is common and undermines treatment success.ObjectiveTo identify predictors of treatment adherence in physical therapy for patients with LBP.Methods209 cases of patients receiving physical therapy for a chief complaint of centralized LBP were retrospectively analyzed for predictors of treatment adherence. Symptom duration, pain intensity, level of disability, the presence of an opioid prescription, and patient cost were assessed as predictors of treatment adherence. Patients who completed their prescribed plan of care were classified as adherent.ResultsLogistic regression analysis revealed that individuals who had an opioid prescription were 2.56 (95% CI = 1.25-5.24, p = 0.010) times less likely to be adherent with treatment compared to individuals without an opioid prescription. Individuals who had symptoms for less than 1 month were 3.21 (95% CI = 1.12-9.24, p = 0.030) times less likely to be adherent with treatment compared to individuals who had experienced symptoms for 4 months to 1 year. Finally, individuals who paid greater than $40 per visit were 3.45 (95% CI = 1.31-9.09, p = 0.011) times less likely to be adherent with treatment compared to individuals who did not have to pay each visit.ConclusionThe results of this study may help clinicians quickly identify and address risk factors for lower treatment adherence in patients with LBP to mitigate the impact of suboptimal treatment adherence on patient outcomes.
治疗依从性是肌肉骨骼疾病（包括腰痛）康复治疗成功的关键。不幸的是，不遵守规定的治疗是常见的，破坏了治疗的成功。目的探讨腰痛患者物理治疗依从性的预测因素。方法回顾性分析209例主诉为集中式腰痛的患者接受物理治疗，寻找治疗依从性的预测因素。症状持续时间、疼痛强度、残疾程度、阿片类药物处方的存在和患者费用被评估为治疗依从性的预测因子。完成规定的治疗计划的患者被归类为坚持治疗。结果logistic回归分析显示，有阿片类药物处方的个体坚持治疗的可能性比没有阿片类药物处方的个体低2.56倍（95% CI = 1.25-5.24, p = 0.010）。症状持续不到1个月的个体与症状持续4个月至1年的个体相比，坚持治疗的可能性低3.21倍（95% CI = 1.12-9.24, p = 0.030）。最后，每次就诊支付超过40美元的个体与不需要每次就诊的个体相比，坚持治疗的可能性低3.45倍（95% CI = 1.31-9.09, p = 0.011）。结论本研究的结果可以帮助临床医生快速识别和解决下腰痛患者治疗依从性降低的危险因素，以减轻治疗依从性不佳对患者预后的影响。
期刊介绍：
The Journal of Back and Musculoskeletal Rehabilitation is a journal whose main focus is to present relevant information about the interdisciplinary approach to musculoskeletal rehabilitation for clinicians who treat patients with back and musculoskeletal pain complaints. It will provide readers with both 1) a general fund of knowledge on the assessment and management of specific problems and 2) new information considered to be state-of-the-art in the field. The intended audience is multidisciplinary as well as multi-specialty.
In each issue clinicians can find information which they can use in their patient setting the very next day.
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