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Racial and Ethnic Disparities in the Incidence of High-Impact Chronic Pain Among Primary Care Patients with Acute Low Back Pain: A Cohort Study.
Roseen, Eric J; Smith, Clair N; Essien, Utibe R; Cozier, Yvette C; Joyce, Christopher; Morone, Natalia E; Phillips, Russell S; Gergen Barnett, Katherine; Patterson, Charity G; Wegener, Stephen T; Brennan, Gerard P; Delitto, Anthony; Saper, Robert B; Beneciuk, Jason M; Stevans, Joel M.
Affiliation
  • Roseen EJ; Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts, USA.
  • Smith CN; Department of Rehabilitation Sciences, MGH Institute for Health Professions, Boston, Massachusetts, USA.
  • Essien UR; Department of Physical Medicine and Rehabilitation, VA Boston Healthcare System, Boston, Massachusetts, USA.
  • Cozier YC; University of Pittsburgh School of Health and Rehabilitation Sciences, Pittsburgh, Pennsylvania, USA.
  • Joyce C; Division of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
  • Morone NE; Slone Epidemiology Center, Boston University School of Public Health, Boston, Massachusetts, USA.
  • Phillips RS; School of Physical Therapy, Massachusetts College of Pharmacy and Health Sciences, Worcester, Massachusetts, USA.
  • Gergen Barnett K; Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts, USA.
  • Patterson CG; Center for Primary Care, Harvard Medical School, Boston, Massachusetts, USA.
  • Wegener ST; Division of General Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
  • Brennan GP; Department of Family Medicine, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts, USA.
  • Delitto A; University of Pittsburgh School of Health and Rehabilitation Sciences, Pittsburgh, Pennsylvania, USA.
  • Saper RB; Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
  • Beneciuk JM; Department of Physical Therapy, Intermountain Healthcare Rehabilitation Services, Murray, Utah, USA.
  • Stevans JM; University of Pittsburgh School of Health and Rehabilitation Sciences, Pittsburgh, Pennsylvania, USA.
Pain Med ; 24(6): 633-643, 2023 06 01.
Article in En | MEDLINE | ID: mdl-36534910
OBJECTIVE: We assessed whether race or ethnicity was associated with the incidence of high-impact chronic low back pain (cLBP) among adults consulting a primary care provider for acute low back pain (aLBP). METHODS: In this secondary analysis of a prospective cohort study, patients with aLBP were identified through screening at seventy-seven primary care practices from four geographic regions. Incidence of high-impact cLBP was defined as the subset of patients with cLBP and at least moderate disability on Oswestry Disability Index [ODI >30]) at 6 months. General linear mixed models provided adjusted estimates of association between race/ethnicity and high-impact cLBP. RESULTS: We identified 9,088 patients with aLBP (81.3% White; 14.3% Black; 4.4% Hispanic). Black/Hispanic patients compared to White patients, were younger and more likely to be female, obese, have Medicaid insurance, worse disability on ODI, and were at higher risk of persistent disability on STarT Back Tool (all P < .0001). At 6 months, more Black and Hispanic patients reported high-impact cLBP (30% and 25%, respectively) compared to White patients (15%, P < .0001, n = 5,035). After adjusting for measured differences in socioeconomic and back-related risk factors, compared to White patients, the increased odds of high-impact cLBP remained statistically significant for Black but not Hispanic patients (adjusted odds ration [aOR] = 1.40, 95% confidence interval [CI]: 1.05-1.87 and aOR = 1.25, 95%CI: 0.83-1.90, respectively). CONCLUSIONS: We observed an increased incidence of high-impact cLBP among Black and Hispanic patients compared to White patients. This disparity was partly explained by racial/ethnic differences in socioeconomic and back-related risk factors. Interventions that target these factors to reduce pain-related disparities should be evaluated. CLINICALTRIALS.GOV IDENTIFIER: NCT02647658.
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Full text: 1 Database: MEDLINE Main subject: Low Back Pain / Chronic Pain Type of study: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limits: Adult / Female / Humans / Male Country/Region as subject: America do norte Language: En Journal: Pain Med Journal subject: NEUROLOGIA / PSICOFISIOLOGIA Year: 2023 Type: Article Affiliation country: United States

Full text: 1 Database: MEDLINE Main subject: Low Back Pain / Chronic Pain Type of study: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limits: Adult / Female / Humans / Male Country/Region as subject: America do norte Language: En Journal: Pain Med Journal subject: NEUROLOGIA / PSICOFISIOLOGIA Year: 2023 Type: Article Affiliation country: United States