Highlights
- •Pain intensity and disability predict 12-month pain-related utilization and costs.
- •Mediation effects are outcome-specific, and more consistent for cost outcomes.
- •Baseline pain intensity may drive volume of health care, including opioid use.
- •Elevated catastrophizing and symptom distribution may drive higher cost service use.
Abstract
Perspective
Key Words
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- Identifying heavy health care users among primary care patients with chronic non-cancer pain.Can J Pain. 2017; 1: 22-36
- The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations.J Pers Soc Psychol. 1986; 51: 1173-1182
- Low back pain in primary care: Costs of care and prediction of future health care utilization.Spine. 2010; 35: 1714-1720
- The triple aim: Care, health, and cost.Health Aff Proj Hope. 2008; 27: 759-769
- The Lower Extremity Functional Scale (LEFS): Scale development, measurement properties, and clinical application. North American Orthopaedic Rehabilitation Research Network.Phys Ther. 1999; 79: 371-383
- Extent measurement in localised low-back pain: A comparison of four methods.Pain. 1994; 59: 281-285
- Setting value-based payment goals – HHS efforts to improve U.S. health care.N Engl J Med. 2015; 372: 897-899
- Prediction of future chronic opioid use among hospitalized patients.J Gen Intern Med. 2018; 33: 898-905
- Psychometric properties of the Neck Disability Index and Numeric Pain Rating Scale in patients with mechanical neck pain.Arch Phys Med Rehabil. 2008; 89: 69-74
- Independent associations of socioeconomic factors with disability and pain in adults with knee osteoarthritis.BMC Musculoskelet Disord. 2013; 14: 297
- The Concentration and Persistence in the Level of Health Expenditures Over Time: Estimates for the U.S. Population, 2008-2009. Statistical Brief #354. [Internet].Agency for Healthcare Research and Quality, Rockville, MD2012 Jan (Available from:)
- Is there an association between whole-body pain with osteoarthritis-related knee pain, pain catastrophizing, and mental health?.Clin Orthop. 2015; 473: 3894-3902
- Opioid use among adolescent patients treated for headache.J Adolesc Health Off Publ Soc Adolesc Med. 2014; 55: 128-133
- Back pain in primary care: predictors of high health-care costs.Pain. 1996; 65: 197-204
- The Oswestry Disability Index.Spine. 2000; 25 (discussion 2952): 2940-2952
Federal agencies partner for military and veteran pain management research [Internet]. Natl. Inst. Health NIH. 2017 [cited 2019 February 6]. Available from:https://www.nih.gov/news-events/news-releases/federal-agencies-partner-military-veteran-pain-management-research
- Individual differences in pain responses.Curr Rheumatol Rep. 2005; 7: 342-347
- Optimal Screening for Prediction of Referral and Outcome (OSPRO) for musculoskeletal pain conditions: Results from the validation cohort.J Orthop Sports Phys Ther. 2018; 48: 460-475
- Introduction to Mediation, Moderation, and Conditional Process Analysis: Second Edition: A Regression-Based Approach [Internet].2nd ed. Guilford Press, New York, NY2017 ([cited 2019 Jan 7]Available from:)
- Does age affect the relationship between pain and disability? A descriptive study in individuals suffering from chronic low back pain.J Geriatr Phys Ther 2001. 2016; 39: 140-145
- Prediction of healthcare utilization following an episode of physical therapy for musculoskeletal pain.BMC Health Serv Res. 2018; 18: 648
- Use of electronic health records for early detection of high-cost, low back pain patients.Pain Res Manag. 2015; 20: 234-240
- Statistical models for the analysis of skewed healthcare cost data: A simulation study.Health Econ Rev. 2015; 5: 11
- Review of statistical methods for analysing healthcare resources and costs.Health Econ. 2011; 20: 897-916
- Psychometric properties of the shortened disabilities of the Arm, Shoulder, and Hand Questionnaire (QuickDASH) and Numeric Pain Rating Scale in patients with shoulder pain.J Shoulder Elbow Surg. 2009; 18: 920-926
- Catastrophizing and pain-related fear predict failure to maintain treatment gains following participation in a pain rehabilitation program.Pain Rep. 2016; 1: e567
- Sleep disorders and associated medical comorbidities in active duty military personnel.Sleep. 2013; 36: 167-174
- Severe pain in veterans: The impact of age and sex, and comparisons to the general population.J Pain Off J Am Pain Soc. 2017; 18: 247-254
NIH-DoD-VA Pain Management Collaboratory [Internet]. [cited 2019 February 6]. Available from: https://painmanagementcollaboratory.org
- Factor structure, reliability, and validity of the Pain Catastrophizing Scale.J Behav Med. 1997; 20: 589-605
- Bundle payment for musculoskeletal care: Current evidence (part 1).Orthop Clin N Am. 2018; 49: 135-146
- Bundle payment for musculoskeletal care: current evidence (part 2).Orthop Clin N Am. 2018; 49: 147-156
- Clinical guidelines committee of the American College of Physicians: Noninvasive treatments for acute, subacute, and chronic low back pain: A clinical practice guideline from the American College of Physicians.Ann Intern Med. 2017; 166: 514-530
- The role of sex/gender in the experience of pain: resilience, fear, and acceptance as central variables in the adjustment of men and women with chronic pain.J Pain Off J Am Pain Soc. 2014; 15 (.e1): 608-618
- Leveraging healthcare utilization to explore outcomes from musculoskeletal disorders: methodology for defining relevant variables from a health services data repository.BMC Med Inform Decis Mak. 2018; 18: 10
- Unique contributions of body diagram scores and psychosocial factors to pain intensity and disability in patients with musculoskeletal pain.J Orthop Sports Phys Ther. 2017; 47: 88-96
- Predictors of chronic prescription opioid use after orthopedic surgery: derivation of a clinical prediction rule.Perioper Med Lond Engl. 2018; 7: 25
- Sex differences in musculoskeletal pain.Clin J Pain. 2001; 17: 20-24
- Measuring shoulder function: A systematic review of four questionnaires.Arthritis Rheum. 2009; 61: 623-632
- Impact of co-morbidities on resource use and adherence to guidelines among commercially insured adults with new visits for back pain.J Eval Clin Pract. 2017; 23: 1218-1226
- Determinants of major direct medical cost categories among patients with osteoporosis, osteoarthritis, back pain or fibromyalgia undergoing outpatient rehabilitation.J Rehabil Med. 2011; 43: 703-708
- Pain catastrophizing predicts pain intensity, disability, and psychological distress independent of the level of physical impairment.Clin J Pain. 2001; 17: 165-172
- Body pain area and pain-related negative affect predict clinical pain intensity in patients with fibromyalgia.J Pain Off J Am Pain Soc. 2004; 5: 338-343
- The pain Catastrophizing Scale: Development and validation.Psychol Assess. 1995; 7: 524-532
- Do medical conditions predispose to the development of chronic back pain? A longitudinal co-twin control study of middle-aged males with 11-year follow-up.BMC Musculoskelet Disord. 2018; 19: 362
- Chronic widespread pain drawn on a body diagram is a screening tool for increased pain sensitization, psycho-social load, and utilization of pain management strategies.Pain Pract Off J World Inst Pain. 2016; 16: 31-37
- United States national pain strategy for population research: Concepts, definitions, and pilot data.J Pain Off J Am Pain Soc. 2016; 17: 1068-1080
- The association between pain diagram area, fear-avoidance beliefs, and pain catastrophising.Chiropr Man Ther. 2014; 22: 5
- Defining risk of prescription opioid overdose: pharmacy shopping and overlapping prescriptions among long-term opioid users in medicaid.J Pain Off J Am Pain Soc. 2015; 16: 445-453
Article info
Publication history
Footnotes
Research funding: Dr. Lentz received support for this project from the Foundation for Physical Therapy with Promotion of Doctoral Studies (PODS I & II) Awards. The National Center for Complementary and Integrative Health provided funding through UG3AT009790 (Dr. George for manuscript planning and writing) and UG3AT009763 (Dr. Rhon for manuscript planning and writing) awards.
Conflicts of interest: The authors declare no conflicts of interest.
Disclosures: The view(s) expressed herein are those of the author(s) and do not reflect the official policy or position of Madigan Army Medical Center, Brooke Army Medical Center, the U.S. Army Medical Department, the U.S. Army Office of the Surgeon General, the Department of the Army, the Department of the Air Force, Department of Defense, or the U.S. Government.