Factors associated with nonpharmacological treatment use among older adults with chronic low back pain tapering opioids.

IF 1.5 Q4 CLINICAL NEUROLOGY
Liang-Yuan Lin, Omkar Ghodke, Cynthia Siddiqua, Sonia Eden, Yi Yang, Kaustuv Bhattacharya
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引用次数: 0

Abstract

Aims: To examine multilevel factors associated with nonpharmacological treatment (NPT) use during opioid tapering among older adults with chronic low back pain (cLBP).

Methods: A cohort study was conducted using 2012-2020 5% national Medicare data. Older adults ≥65 with cLBP who initiated long-term opioid therapy and experienced subsequent tapering were included. The primary outcome was the receipt of NPT within 90 days of tapering. Guided by the social ecological model, predictors were assessed across individual, interpersonal, community, and organizational levels. Multivariable logistic regression was used to evaluate associations with NPT use.

Results: A total of 10,811 eligible beneficiaries were identified. NPT use was more likely among Asian and female individuals, while those receiving partial low-income subsidies had lower odds. Residing in counties with more mental health providers and social associations was linked to higher NPT use. Prior NPT use, higher baseline opioid dose, rapid tapering, mental health conditions, substance use disorders, additional pain diagnoses, and higher comorbidity burden were associated with increased odds of NPT use.

Conclusion: This study identified key factors affecting NPT use during opioid tapering among older adults with cLBP. Findings underscore the importance of targeted clinical and policy strategies to reduce disparities in NPT access.

慢性腰痛老年人非药物治疗使用阿片类药物的相关因素。
目的:研究慢性腰痛(cLBP)老年人阿片类药物逐渐减少期间非药物治疗(NPT)使用相关的多水平因素。方法:采用2012-2020年5%的国家医疗保险数据进行队列研究。年龄≥65岁的cLBP患者开始长期阿片类药物治疗并经历了随后的逐渐减少。主要成果是在缩减后90天内收到NPT。在社会生态模型的指导下,对个体、人际、社区和组织层面的预测因子进行了评估。使用多变量逻辑回归来评估与NPT使用的关系。结果:共确定了10811名符合条件的受益人。亚洲人和女性更有可能使用《不扩散核武器条约》,而那些接受部分低收入补贴的人的可能性较低。居住在拥有更多精神保健提供者和社会协会的县,与NPT使用率较高有关。既往使用非扩散药物、较高的基线阿片类药物剂量、快速减量、精神健康状况、物质使用障碍、额外的疼痛诊断和较高的合并症负担与非扩散药物使用几率增加有关。结论:本研究确定了影响老年cLBP患者阿片类药物减量期间NPT使用的关键因素。研究结果强调了有针对性的临床和政策战略的重要性,以减少不扩散核武器条约获取方面的差距。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Pain management
Pain management CLINICAL NEUROLOGY-
CiteScore
2.90
自引率
5.90%
发文量
62
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