Factors Influencing Work Interference in Patients With Chronic Low Back Pain: A Residency Research Network of Texas (RRNeT) Study Full Text
Journal of the American Board of Family Medicine, 09/19/2011
Young RA et al. – Future studies attempting to demonstrate the effectiveness of interventions in Chronic low back pain (CLBP) should measure depressive symptoms and the magnitude and effect of painful flare–ups, not just the overall pain score. The majority of CLBP patients seen in these practices take opioids for their pain. Screening and treating for depression may be reasonable for some patients, though evidence of its effectiveness is lacking.Methods
- 360 outpatients with CLBP for more than 3 months.
- 10 participating family physicians' offices of the Residency Research Network of Texas.
- The effect of pain on work effect as measured by a Likert scale.
- Patients were typically female (72%), overweight or obese (mean body mass index, 33.4), had pain for many years (mean, 13.6 years), and screened positive for recent depressive symptoms (83%).
- The majority of patients took at least some opioid medication for their pain (59%).
- Multivariate linear regression analysis found that the larges single contributor to effect on work was the subjects' score on the SF–36 physical function scale (beta = –0.382).
- Other contributors included average daily pain (beta = 0.189), the frequency of flare–ups of pain (beta = 0.108), the effect of the painful flare–ups (beta = 0.170), and current depressive symptoms (beta = 0.131) (adjusted R2 for model = 0.535).
- Age, sex, race/ethnicity, total time the patient has had CLBP, other comorbidities (including a diagnosis of depression), disability status, use of opioids, history of intimate partner violence, social support, and procedures attempted were not predictive.