Prevalence of Complementary Studies in Patients with Spinal Conditions in a Public Hospital in Buenos Aires - A Descriptive Cross-Sectional Study
Journal: Advances in Medicine and Engineering Interdisciplinary Research DOI: 10.32629/ameir.v3i2.3799
Abstract
Objective: To determine the prevalence of complementary studies (CS) in patients with spinal conditions attending the Physical Therapy Department of a public hospital in the Autonomous City of Buenos Aires. As secondary objectives, we aimed to calculate the direct costs of CS in patients with low back pain (LBP), neck pain (NP), and the prevalence of red flags in LBP. Materials and methods: A cross-sectional study was included. Patients with spinal cord disease, aged 18 years or older, and who provided informed consent were included. Results: The prevalence of CS in the general population was 83%. 87.5% of patients with LBP had at least one red flag. The total cost of CS was $210,133 (US$3,431), and the average cost per subject was $1,129 (US$18) in the general population. Conclusion: The prevalence of CS among patients with spinal cord disorders was 83%, resulting in an average cost of $1,129 (US$18) per subject. When assessing the presence of red flags, 87.5% of subjects with LBP had at least one.
Keywords
Argentina; low back pain; neck pain; diagnostic imaging; public hospitals
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[2] Blanpied PR, Gross AR, Elliott JM, Devaney LL, Clewley D, Walton DM, et al. Neck pain: revision 2017. J Orthop Sports Phys Ther. 2017 Jul;47(7):A1-A83.
[3] Walker BF. The prevalence of low back pain: a systematic review of the literature from 1966 to 1998. J Spinal Disord. 2000 Jun;13(3):205-17.
[4] Côté P, Cassidy JD, Carroll LJ, Kristman V. The annual incidence and course of neck pain in the general population: a population-based cohort study. Pain. 2004 Dec;112(3):267-73.
[5] Hartvigsen J, Hancock MJ, Kongsted A, Louw Q, Ferreira ML, Genevay S, et al. Lancet Low Back Pain Series Working Group. What low back pain is and why we need to pay attention. Lancet. 2018 Jun 9;391(10137):2356-2367.
[6] GBD 2016 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017 Sep 16;390(10100):1211-1259.
[7] Maniadakis N, Gray A. The economic burden of back pain in the UK. Pain. 2000 Jan;84(1):95-103
[8] Darlow B, Forster BB, O'Sullivan K, O'Sullivan P. It is time to stop causing harm with inappropriate imaging for low back pain. Br J Sports Med. 2017 Mar;51(5):414-415.
[9] Brinjikji W, Luetmer PH, Comstock B, Bresnahan BW, Chen LE, Deyo RA, et al. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR Am J Neuroradiol. 2015 Apr;36(4):811-6.
[10] Kendrick D, Fielding K, Bentley E, Kerslake R, Miller P, Pringle M. Radiography of the lumbar spine in primary care patients with low back pain: randomised controlled trial. BMJ. 2001 Feb 17;322(7283):400-5.
[11] Lemmers GPG, van Lankveld W, Westert GP, van der Wees PJ, Staal JB. Imaging versus no imaging for low back pain: a systematic review, measuring costs, healthcare utilization and absence from work. Eur Spine J. 2019 May;28(5):937-950.
[12] Lin I, Wiles L, Waller R, Goucke R, Nagree Y, Gibberd M, et al. What does best practice care for musculoskeletal pain look like? Eleven consistent recommendations from high-quality clinical practice guidelines: systematic review. Br J Sports Med. 2020 Jan;54(2):79-86.
[13] Haldeman S, Kopansky-Giles D, Hurwitz EL, Hoy D, Mark Erwin W, Dagenais S, et al. Advancements in the management of spine disorders. Best Pract Res Clin Rheumatol. 2012 Apr;26(2):263-80.
[14] Henschke N, Maher CG, Refshauge KM, Herbert RD, Cumming RG, Bleasel J, et al. Prevalence of and screening for serious spinal pathology in patients presenting to primary care settings with acute low back pain. Arthritis Rheum. 2009 Oct;60(10):3072-80.
[15] Downie A, Hancock M, Jenkins H, Buchbinder R, Harris I, Underwood M, et al. How common is imaging for low back pain in primary and emergency care? Systematic review and meta-analysis of over 4 million imaging requests across 21 years. Br J Sports Med. 2019 Feb 13:bjsports-2018-100087.
[16] Soriano ER, Zingoni C, Lucco F, Catoggio LJ. Consultations for work related low back pain in Argentina. J Rheumatol. 2002May;29(5):1029-33.
[17] von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP; STROBE Initiative. The strengthening the reporting of observational studies in epidemiology (strobe) statement: guidelines for reporting observational studies. Prev Med. 2007 Oct;45(4):247-51.
[18] Cook CE, George SZ, Reiman MP. Red flag screening for low back pain: nothing to see here, move along: a narrative review. Br J Sports Med. 2018 Apr;52(8):493-496.
[19] Chou R, Qaseem A, Owens DK, Shekelle P; Clinical guidelines committee of the American college of physicians. diagnostic imaging for low back pain: advice for high-value health care from the American college of physicians. Ann Intern Med. 2011 Feb 1;154(3):181-9.
[20] Premkumar A, Godfrey W, Gottschalk MB, Boden SD. Red flags for low back pain are not always really red: a prospective evaluation of the clinical utility of commonly used screening questions for low back pain. J Bone Joint Surg Am. 2018 Mar 7;100(5):368-374.
[21] Jenkins HJ, Downie AS, Maher CG, Moloney NA, Magnussen JS, Hancock MJ. Imaging for low back pain: is clinical use consistent with guidelines? A systematic review and meta-analysis. Spine J. 2018;18(12):2266-2277.
[22] Yates M, Oliveira CB, Galloway JB, Maher CG. Defining and measuring imaging appropriateness in low back pain studies: a scoping review. Eur Spine J. 2020 Mar;29(3):519-529.
[23] Logan GS, Pike A, Copsey B, Parfrey P, Etchegary H, Hall A. What do we really know about the appropriateness of radiation emitting imaging for low back pain in primary and emergency care? A systematic review and meta-analysis of medical record reviews. PLoS One. 2019 Dec 5;14(12):e0225414.
[24] Webster BS, Cifuentes M. Relationship of early magnetic resonance imaging for work-related acute low back pain with disability and medical utilization outcomes. J Occup Environ Med. 2010 Sep;52(9):900-7.
[25] Dagenais S, Caro J, Haldeman S. A systematic review of low back pain cost of illness studies in the United States and internationally. Spine J. 2008 Jan-Feb;8(1):8-20.
[26] Depont F, Hunsche E, Abouelfath A, Diatta T, Addra I, Grelaud A, et al. Medical and non-medical direct costs of chronic low back pain in patients consulting primary care physicians in France. Fundam Clin Pharmacol. 2010 Feb;24(1):101-8.
[27] Ritzwoller DP, Crounse L, Shetterly S, Rublee D. The association of comorbidities, utilization and costs for patients identified with low back pain. BMC Musculoskelet Disord. 2006 Sep 18;7:72.
[28] Gilbert FJ, Grant AM, Gillan MG, Vale L, Scott NW, Campbell MK, et al. Does early imaging influence management and improve outcome in patients with low back pain? A pragmatic randomised controlled trial. Health Technol Assess. 2004 May;8(17):iii, 1-131.
[29] Babu AN, McCormick Z, Kennedy DJ, Press J. Local, national, and service component cost variations in the management of low back pain: Considerations for the clinician. J Back Musculoskelet Rehabil. 2016 Nov 21;29(4):685-692.
[30] Patel ND, Broderick DF, Burns J, Deshmukh TK, Fries IB, Harvey HB, et al. ACR appropriateness criteria low back pain. J Am Coll Radiol. 2016 Sep;13(9):1069-78.
[31] Hall AM, Scurrey SR, Pike AE, Albury C, Richmond HL, Matthews J, et al. Physician-reported barriers to using evidence-based recommendations for low back pain in clinical practice: a systematic review and synthesis of qualitative studies using the Theoretical Domains Framework. Implement Sci. 2019 May 7;14(1):49.
[32] Slade SC, Kent P, Patel S, Bucknall T, Buchbinder R. Barriers to primary care clinician adherence to clinical guidelines for the management of low back pain: a systematic review and metasynthesis of qualitative studies. Clin J Pain. 2016 Sep;32(9):800-16.
[33] Reijneveld SA, Stronks K. The validity of self-reported use of health care across socioeconomic strata: a comparison of survey and registration data. Int J Epidemiol. 2001 Dec;30(6):1407-14.
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