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Treatment Preferences for Chronic Low Back Pain: Views of Veterans and Their Providers

Authors Belitskaya-Levy I, Clark JD, Shih MC, Bair MJ

Received 11 November 2020

Accepted for publication 15 December 2020

Published 27 January 2021 Volume 2021:14 Pages 161—171


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Michael Schatman

Ilana Belitskaya-Levy,1 J David Clark,2,3 Mei-Chiung Shih,1 Matthew J Bair4– 6

1VA Cooperative Studies Program Coordinating Center – Mountain View Division, Palo Alto Healthcare System, Mountain View, CA, USA; 2Anesthesiology Service, VA Palo Alto Health Care System, Palo Alto, CA, USA; 3Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Stanford, CA, USA; 4VA HSR&D Center for Health Information and Communication, Roudebush VA Medical Center, Indianapolis, IN, USA; 5Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA; 6Regenstrief Institute, Inc., Indianapolis, IN, USA

Correspondence: Matthew J Bair
VA HSR&D Center for Health Information and Communication, Roudebush VA Medical Center, 1481 W. 10th St. (11H), Indianapolis, IN 46202, USA
Tel +1 (317) 988-2058
Fax +1 (317) 988-5361

Purpose: This study was conducted to characterize chronic low back pain (cLBP) and to identify treatment histories and preferences for cLBP management among Veterans and primary care providers within the Veterans Affairs (VA) healthcare system.
Participants and Methods: Veterans with cLBP from five geographically diverse VA medical centers were identified using International Classification of Diseases (ICD) 9 and 10 codes from VA administrative data as were primary care providers at these same sites. From these data, Veterans (200/per site) and providers (160/per site) were selected and mailed surveys. Open-ended interview data were collected from a subset of Veterans and providers.
Results: In total, 235 Veterans and 67 providers returned completed surveys. More than 80% of the Veteran respondents had daily back pain for more than 1 year. Most Veterans had tried several treatments for their pain with medications and physical therapy being the most commonly used. Veterans and providers had similar attitudes towards many cLBP treatments with the exception of psychological therapies that were more favored by providers. Open-ended interview data showed that Veterans and providers emphasized the need for multi-component approaches to treatment.
Conclusion: Among Veterans, cLBP is typically of sustained duration, is relatively severe, and also interferes significantly with normal functioning. Veterans are experienced with respect to treatments and had similar attitudes towards many cLBP treatments as their providers, especially tailored approaches.

Keywords: low back pain, chronic pain, survey, preferences, primary care provider

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