Table 5 |
||||||||||
|
Factors Associated with Medical Management during Patient Visits in which Low Back Pain was the Primary Reason for Seeking Care, 2003–2004 (n = 710)* |
||||||||||
|
Medical Management |
||||||||||
|
|
||||||||||
|
Exercise Counseling |
Any Patient Counseling |
Narcotic Analgesic |
NSAID |
Any Drug |
||||||
|
|
|
|
|
|
||||||
|
Characteristic |
OR† |
95% CI |
OR† |
95% CI |
OR† |
95% CI |
OR† |
95% CI |
OR† |
95% CI |
|
|
||||||||||
|
Patient age, y |
||||||||||
|
<25 |
0.53 |
0.15 – 1.90 |
0.64 |
0.27 – 1.53 |
0.35 |
0.11 – 1.11 |
0.93 |
0.44·1.94 |
0.19 |
0.08 – 0.50 |
|
25–44 |
1.00 |
... |
1.00 |
... |
1.00 |
... |
1.00 |
... |
1.00 |
... |
|
45–64 |
1.20 |
0.66 – 2.19 |
1.08 |
0.66 – 1.75 |
0.80 |
0.47 – 1.36 |
0.64 |
0.39·1.06 |
0.63 |
0.36 – 1.09 |
|
≥65 |
0.93 |
0.47 – 1.83 |
0.67 |
0.38 – 1.19 |
0.42 |
0.21 – 0.84 |
0.73 |
0.44·1.20 |
0.77 |
0.38 – 1.56 |
|
Patient sex |
||||||||||
|
Female |
1.00 |
... |
1.00 |
... |
1.00 |
... |
1.00 |
... |
1.00 |
... |
|
Male |
0.85 |
0.52 – 1.38 |
0.91 |
0.62 – 1.36 |
0.90 |
0.59 – 1.39 |
0.99 |
0.68·1.45 |
0.76 |
0.50 – 1.14 |
|
Patient race |
||||||||||
|
White |
1.00 |
... |
1.00 |
... |
1.00 |
... |
1.00 |
... |
1.00 |
... |
|
Non-White |
0.66 |
0.23 – 1.89 |
0.49 |
0.25 – 0.96 |
0.91 |
0.42 – 2.01 |
1.30 |
0.60·2.84 |
3.54 |
1.40 – 8.97 |
|
Patient ethnicity |
||||||||||
|
Non-Hispanic |
1.00 |
... |
1.00 |
... |
1.00 |
... |
1.00 |
... |
1.00 |
... |
|
Hispanic |
1.45 |
0.77 – 2.77 |
1.45 |
0.77 – 2.77 |
0.30 |
0.11 – 0.76 |
1.12 |
0.53·2.36 |
1.78 |
0.73 – 4.36 |
|
Geographic region |
||||||||||
|
Northeast |
1.00 |
... |
1.00 |
... |
1.00 |
... |
1.00 |
... |
1.00 |
... |
|
Midwest |
0.33 |
0.14 – 0.78 |
0.29 |
0.14 – 0.60 |
1.18 |
0.43 – 3.24 |
2.05 |
0.93 – 4.49 |
2.00 |
0.67 – 5.97 |
|
South |
0.27 |
0.13 – 0.56 |
0.36 |
0.17 – 0.74 |
1.16 |
0.50 – 2.72 |
1.81 |
0.84 – 3.90 |
2.23 |
0.98 – 5.08 |
|
West |
0.59 |
0.26 – 1.34 |
0.45 |
0.22 – 0.93 |
1.56 |
0.63 – 3.84 |
1.45 |
0.67 – 3.14 |
1.85 |
0.75 – 4.56 |
|
MSA status |
||||||||||
|
MSA |
1.00 |
... |
1.00 |
... |
1.00 |
... |
1.00 |
... |
1.00 |
... |
|
Non-MSA |
0.45 |
0.21 – 0.96 |
0.77 |
0.38 – 1.53 |
1.96 |
1.06 – 3.63 |
0.90 |
0.40 – 2.07 |
2.90 |
0.64 – 13.08 |
|
Chronicity |
||||||||||
|
Acute (initial visit) |
1.00 |
... |
1.00 |
... |
1.00 |
... |
1.00 |
... |
1.00 |
... |
|
Chronic (follow-up visit) |
0.87 |
0.48 – 1.59 |
1.16 |
0.72 – 1.87 |
1.54 |
0.87 – 2.75 |
0.56 |
0.37 – 0.86 |
0.35 |
0.19 – 0.64 |
|
IPA etiology |
||||||||||
|
No |
1.00 |
... |
1.00 |
... |
1.00 |
... |
1.00 |
... |
1.00 |
... |
|
Yes |
2.34 |
1.49 – 3.68 |
2.38 |
1.50 – 3.77 |
0.74 |
0.44 – 1.27 |
1.19 |
0.83 – 1.73 |
0.62 |
0.36 – 1.08 |
|
PCP status |
||||||||||
|
Non-PCP or unknown |
1.00 |
... |
1.00 |
... |
1.00 |
... |
1.00 |
... |
1.00 |
... |
|
PCP |
1.59 |
0.67 – 3.76 |
1.10 |
0.56 – 2.17 |
1.38 |
0.72 – 2.67 |
1.62 |
1.05 – 2.49 |
1.98 |
1.19 – 3.28 |
|
Type of physician |
||||||||||
|
Doctor of Medicine |
1.00 |
... |
1.00 |
... |
1.00 |
... |
1.00 |
... |
1.00 |
... |
|
Doctor of Osteopathy |
1.53 |
0.80 – 2.92 |
1.02 |
0.46 – 2.26 |
0.70 |
0.31 – 1.58 |
0.43 |
0.24 – 0.76 |
0.44 |
0.18 – 1.11 |
|
Physician specialty |
||||||||||
|
Family (general) medicine |
0.30 |
0.12 – 0.74 |
0.71 |
0.32 – 1.59 |
0.99 |
0.46 – 2.12 |
1.52 |
0.79 – 2.92 |
2.38 |
1.06 – 5.35 |
|
Internal medicine |
0.15 |
0.05 – 0.40 |
0.42 |
0.13 – 1.32 |
0.63 |
0.25 – 1.62 |
0.68 |
0.28 – 1.69 |
0.73 |
0.28 – 1.87 |
|
Neurology |
0.24 |
0.06 – 0.94 |
0.50 |
0.18 – 1.39 |
0.88 |
0.38 – 2.05 |
0.94 |
0.43 – 2.04 |
0.86 |
0.38 – 1.98 |
|
Orthopedics |
1.55 |
0.59 – 4.05 |
1.01 |
0.40 – 2.55 |
0.81 |
0.33 – 2.00 |
0.97 |
0.39 – 2.40 |
0.45 |
0.16 – 1.31 |
|
All other specialties |
1.00 |
... |
1.00 |
... |
1.00 |
... |
1.00 |
... |
1.00 |
... |
|
Shared physician care |
||||||||||
|
No or unknown |
1.00 |
... |
1.00 |
... |
1.00 |
... |
1.00 |
... |
1.00 |
... |
|
Yes |
1.13 |
0.62 – 2.08 |
1.08 |
0.62 – 1.87 |
1.61 |
0.95 – 2.76 |
1.28 |
0.70 – 2.36 |
1.02 |
0.60 – 1.75 |
|
|
||||||||||
|
Abbreviations: CI, confidence interval; IPA, injury, poisoning, or adverse effect of medical treatment; MSA, metropolitan statistical area; NSAID, nonsteroidal anti-inflammatory drug; OR, odds ratio; PCP, primary care physician. *Only initial visits for acute problems or follow-up visits for chronic problems were included. †Adjusted for all variables shown. |
||||||||||
|
Licciardone Osteopathic Medicine and Primary Care 2008 2:11 doi:10.1186/1750-4732-2-11 |
||||||||||
