Role of patient-based health status outcome measurements in opioid management for low back pain.
OBJECTIVE
The aim of the study was to identify patient factors that correlate with a strong response to opioid pain medications in low back pain patients.


METHODS
Prospective analysis.


METHODS
Tertiary Institutional Spine Care Center.


METHODS
All patients visiting a tertiary referral spine center with primary diagnosis of low back pain (n = 486) and minimum duration of 6 months.


METHODS
Opioid medication.


METHODS
Analysis factors included visual analog pain scale (VAS), symptom relief scores, and results on 36-item Short Form Health Survey (SF-36). A longitudinal descriptive analysis and a multivariable logistic regression were performed on the results of the VAS and SF-36 scores.


RESULTS
The average age of opioid and nonopioid treated patients was 62 years versus 64 years, (p = 0.13) and gender distributions at 53 percent versus 50 percent female (p = 0.43). SF-36 scores were statistically significant and associated with the opioid categorization. For every unit increase in symptom relief score, the likelihood of opioid use is doubled (OR = 2.1, 95 percent CI = 1.5-2.8, p < 0.001); and increased by 25 percent with each 10-point decrease in the social functioning quality of life score (OR = 0.98, 95 percent CI = 0.96-0.99, p = 0.006).


CONCLUSIONS
Social quality of life and symptom relief measurements comprise the optimal set of independent factors that correlate most strongly with a response to opioid use in low back pain patients.
Podichetty
Vinod K
VK
Division of Research Medical Intervention & Surgical Spine Program, Cleveland Clinic Florida, Weston, Florida, USA.
Varley
Eric S
ES
Secic
Michelle
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D015331:Cohort Studies; D016208:Databases, Factual; D005260:Female; D005431:Florida / Q000453:epidemiology; D019538:Health Care Surveys; D006305:Health Status Indicators; D006801:Humans; D016015:Logistic Models; D017116:Low Back Pain / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D016896:Treatment Outcome
D000701:Analgesics, Opioid