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Trends in the Use of Opioids vs Nonpharmacologic Treatments in Adults With Pain, 2011-2019
IMPORTANCE: Chronic pain prevalence among US adults increased between 2010 and 2019. Yet little is known about trends in the use of prescription opioids and nonpharmacologic alternatives in treating pain. OBJECTIVES: To compare annual trends in the use of prescription opioids, nonpharmacologic alter...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
American Medical Association
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9641539/ https://www.ncbi.nlm.nih.gov/pubmed/36342717 http://dx.doi.org/10.1001/jamanetworkopen.2022.40612 |
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author | Pritchard, Kevin T. Baillargeon, Jacques Lee, Wei-Chen Raji, Mukaila A. Kuo, Yong-Fang |
author_facet | Pritchard, Kevin T. Baillargeon, Jacques Lee, Wei-Chen Raji, Mukaila A. Kuo, Yong-Fang |
author_sort | Pritchard, Kevin T. |
collection | PubMed |
description | IMPORTANCE: Chronic pain prevalence among US adults increased between 2010 and 2019. Yet little is known about trends in the use of prescription opioids and nonpharmacologic alternatives in treating pain. OBJECTIVES: To compare annual trends in the use of prescription opioids, nonpharmacologic alternatives, both treatments, and neither treatment; compare estimates for the annual use of acupuncture, chiropractic care, massage therapy, occupational therapy, and physical therapy; and estimate the association between calendar year and pain treatment based on the severity of pain interference. DESIGN, SETTING, AND PARTICIPANTS: A serial cross-sectional analysis was conducted using the nationally representative Medical Expenditure Panel Survey to estimate the use of outpatient services by cancer-free adults with chronic or surgical pain between calendar years 2011 and 2019. Data analysis was performed from December 29, 2021, to August 5, 2022. EXPOSURES: Calendar year (2011-2019) was the primary exposure. MAIN OUTCOMES AND MEASURES: The association between calendar year and mutually exclusive pain treatments (opioid vs nonpharmacologic vs both vs neither treatment) was examined. A secondary outcome was the prevalence of nonpharmacologic treatments (acupuncture, chiropractic care, massage therapy, occupational therapy, and physical therapy). All analyses were stratified by pain type. RESULTS: Among the unweighted 46 420 respondents, 9643 (20.4% weighted) received surgery and 36 777 (79.6% weighted) did not. Weighted percentages indicated that 41.7% of the respondents were aged 45 to 64 years and 55.0% were women. There were significant trends in the use of pain treatments after adjusting for demographic factors, socioeconomic status, health conditions, and pain severity. For example, exclusive use of nonpharmacologic treatments increased in 2019 for both cohorts (chronic pain: adjusted odds ratio [aOR], 2.72; 95% CI, 2.30-3.21; surgical pain: aOR, 1.53; 95% CI, 1.13-2.08) compared with 2011. The use of neither treatment decreased in 2019 for both cohorts (chronic pain: aOR, 0.43; 95% CI, 0.37-0.49; surgical pain: aOR, 0.59; 95% CI, 0.46-0.75) compared with 2011. Among nonpharmacologic treatments, chiropractors and physical therapists were the most common licensed healthcare professionals. CONCLUSIONS AND RELEVANCE: Among cancer-free adults with pain, the annual prevalence of nonpharmacologic pain treatments increased and the prevalent use of neither opioids nor nonpharmacologic therapy decreased for both chronic and surgical pain cohorts. These findings suggest that, although access to outpatient nonpharmacologic treatments is increasing, more severe pain interference may inhibit this access. |
format | Online Article Text |
id | pubmed-9641539 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | American Medical Association |
record_format | MEDLINE/PubMed |
spelling | pubmed-96415392022-11-28 Trends in the Use of Opioids vs Nonpharmacologic Treatments in Adults With Pain, 2011-2019 Pritchard, Kevin T. Baillargeon, Jacques Lee, Wei-Chen Raji, Mukaila A. Kuo, Yong-Fang JAMA Netw Open Original Investigation IMPORTANCE: Chronic pain prevalence among US adults increased between 2010 and 2019. Yet little is known about trends in the use of prescription opioids and nonpharmacologic alternatives in treating pain. OBJECTIVES: To compare annual trends in the use of prescription opioids, nonpharmacologic alternatives, both treatments, and neither treatment; compare estimates for the annual use of acupuncture, chiropractic care, massage therapy, occupational therapy, and physical therapy; and estimate the association between calendar year and pain treatment based on the severity of pain interference. DESIGN, SETTING, AND PARTICIPANTS: A serial cross-sectional analysis was conducted using the nationally representative Medical Expenditure Panel Survey to estimate the use of outpatient services by cancer-free adults with chronic or surgical pain between calendar years 2011 and 2019. Data analysis was performed from December 29, 2021, to August 5, 2022. EXPOSURES: Calendar year (2011-2019) was the primary exposure. MAIN OUTCOMES AND MEASURES: The association between calendar year and mutually exclusive pain treatments (opioid vs nonpharmacologic vs both vs neither treatment) was examined. A secondary outcome was the prevalence of nonpharmacologic treatments (acupuncture, chiropractic care, massage therapy, occupational therapy, and physical therapy). All analyses were stratified by pain type. RESULTS: Among the unweighted 46 420 respondents, 9643 (20.4% weighted) received surgery and 36 777 (79.6% weighted) did not. Weighted percentages indicated that 41.7% of the respondents were aged 45 to 64 years and 55.0% were women. There were significant trends in the use of pain treatments after adjusting for demographic factors, socioeconomic status, health conditions, and pain severity. For example, exclusive use of nonpharmacologic treatments increased in 2019 for both cohorts (chronic pain: adjusted odds ratio [aOR], 2.72; 95% CI, 2.30-3.21; surgical pain: aOR, 1.53; 95% CI, 1.13-2.08) compared with 2011. The use of neither treatment decreased in 2019 for both cohorts (chronic pain: aOR, 0.43; 95% CI, 0.37-0.49; surgical pain: aOR, 0.59; 95% CI, 0.46-0.75) compared with 2011. Among nonpharmacologic treatments, chiropractors and physical therapists were the most common licensed healthcare professionals. CONCLUSIONS AND RELEVANCE: Among cancer-free adults with pain, the annual prevalence of nonpharmacologic pain treatments increased and the prevalent use of neither opioids nor nonpharmacologic therapy decreased for both chronic and surgical pain cohorts. These findings suggest that, although access to outpatient nonpharmacologic treatments is increasing, more severe pain interference may inhibit this access. American Medical Association 2022-11-07 /pmc/articles/PMC9641539/ /pubmed/36342717 http://dx.doi.org/10.1001/jamanetworkopen.2022.40612 Text en Copyright 2022 Pritchard KT et al. JAMA Network Open. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the CC-BY License. |
spellingShingle | Original Investigation Pritchard, Kevin T. Baillargeon, Jacques Lee, Wei-Chen Raji, Mukaila A. Kuo, Yong-Fang Trends in the Use of Opioids vs Nonpharmacologic Treatments in Adults With Pain, 2011-2019 |
title | Trends in the Use of Opioids vs Nonpharmacologic Treatments in Adults With Pain, 2011-2019 |
title_full | Trends in the Use of Opioids vs Nonpharmacologic Treatments in Adults With Pain, 2011-2019 |
title_fullStr | Trends in the Use of Opioids vs Nonpharmacologic Treatments in Adults With Pain, 2011-2019 |
title_full_unstemmed | Trends in the Use of Opioids vs Nonpharmacologic Treatments in Adults With Pain, 2011-2019 |
title_short | Trends in the Use of Opioids vs Nonpharmacologic Treatments in Adults With Pain, 2011-2019 |
title_sort | trends in the use of opioids vs nonpharmacologic treatments in adults with pain, 2011-2019 |
topic | Original Investigation |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9641539/ https://www.ncbi.nlm.nih.gov/pubmed/36342717 http://dx.doi.org/10.1001/jamanetworkopen.2022.40612 |
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