Better prescribing for bad backs

Low back pain is a major cause of disability among adults and a top reason patients are prescribed opioids. However, a recent study in the Journal of the American Board of Family Medicine finds that patients with new low back pain are receiving opioids less frequently, though prescribing rates remain uneven across the country. Given opioids’ limited effectiveness for low back pain and risk of harm to patients, these results are heartening. 

Person wearing a wraparound back brace stands facing a doctor who is pointing out the vertebrae on a model of spine

In the study, associate fellow at the Leonard Davis Institute Jina Pakpoor and co-first author Micheal Raad found that the percentage of patients who filled opioid prescriptions after visiting primary care for new low back pain declined from 29% in 2011 to 20% in 2016. The authors examined the private insurance claims of more than 400,000 individuals who visited primary care with new low back pain and measured whether these patients had filled an opioid prescription within 30 days of their visit. They excluded patients who had visited a subspecialist for their pain, had an additional spinal diagnosis, or had filled opioid prescriptions in the 90 days prior to their encounter.

Pakpoor and her co-authors suggest that the overall decline in opioid prescriptions for new low back pain is likely attributable to greater physician education, statewide prescription drug monitoring programs, and increased awareness around the epidemic

Read more at Penn LDI.