Prescription Medication Use Among Community-Based U.S. Adults With Chronic Low Back Pain: A Cross-Sectional Population Based Study

Shmagel, Anna; Ngo, Linh; Ensrud, Kristine E.; Foley, Robert N.

doi:10.1016/j.jpain.2018.04.004

Cited by 57 publications

(62 citation statements)

References 56 publications

(58 reference statements)

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“…The baseline characteristics of the study population were analysed by drug group. Categorical variables were presented as number and percentage and continuous variables as mean and standard deviation (SD), and compared using Chi test with 2 degrees of freedom and Kruskal–Wallis test. Subjects were censored at death date, last dispensing date or 31 December 2014.…”

Section: Methodsmentioning

confidence: 99%

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Patterns of gabapentin and pregabalin use and misuse: Results of a population‐based cohort study in France

Driot

Jouanjus

Oustric

et al. 2019

Brit J Clinical Pharma

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Aims: The aim of this study was to assess the use and factors associated with the misuse of gabapentin and pregabalin in the general French population, through a cohort study in the EGB (General Sample of Beneficiaries), a national representative sample of the French general population.Methods: New users of gabapentin and pregabalin were identified from June 2006 to December 2014, and new users of duloxetine served as control group. Misuse was defined as a use of higher daily doses than recommended. Cox proportional hazard regression models were performed to identify associated factors of misuse.Results: Misuse was more frequent in the 8692 new users of pregabalin (12.8%) than in the 1963 gabapentin (6.6%) or the 3214 duloxetine new users (9.7%) (P < 0.001). Factors associated with misuse were pregabalin (hazard ratio [HR] 1.48; 95% confidence interval [CI] [1.29-1.69]), age (HR [18-45] versus > 70 years 1.98 [1.70-2.31] and HR [58-70] versus > 70 years 1.25 [1.06-1.47]), multiple prescribers (HR 2 or 3 versus 1 prescriber 1.29 [1.15-1.45]; HR 4 or more versus 1 prescriber 1.54 [1.30-1.83]), cancer (1.28 [1.11-1.47]), multiple sclerosis (1.53 [1.07-2.18]), neuropathy (1.85 [1.19-2.89]), depression (1.26 [1.07-1.49]) and methadone (2.61 [1. 16-5.84]). After this first episode of drug misuse, 11.6% of gabapentin and 10.7% of pregabalin misusers developed a primary addiction.Conclusion: In a cohort of new users, misuse is more likely to occur in new users of pregabalin, with different associated factors of misuse compared to gabapentin and duloxetine. Health professionals and prescribers must be aware of this misuse potential, which could lead to abuse and dependence.

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Section: Methodsmentioning

confidence: 99%

“…Pregabalin and gabapentin, originally presented as anticonvulsants, are now increasingly prescribed for a range of clinical conditions, in particular for chronic pain . These drugs selectively bind to the α2‐δ subunit of voltage‐gated calcium channels in central nervous system neuronal tissues .…”

Section: Introductionmentioning

confidence: 99%

Patterns of gabapentin and pregabalin use and misuse: Results of a population‐based cohort study in France

Driot

Jouanjus

Oustric

et al. 2019

Brit J Clinical Pharma

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“…Although this angle became less vertical, the authors do not necessarily feel that this was a negative result. It has been found that sitting in a more active, erect position requires more muscle activity than sitting in other, more relaxed positions [12,13]. Therefore this increased trunk thigh angle most likely reflects a more relaxed sitting position after becoming accustomed to the device and using it for longer periods of time.…”

Section: Discussionmentioning

confidence: 99%

Does BetterBack Lumbar Support and Posture Trainer Decrease Back Pain and Improve Posture?

Parker¹,

Burns²,

Boyd³

et al. 2019

J Ergonomics

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Background: The incidence of Low Back Pain (LBP) in the United States is a common occurrence. One proposed cause is poor posture characterized by reduced lumbar lordosis while sitting. Proper retraining of seated posture could potentially increase lumbar lordosis and therefore reduce LBP. Various lumbar support devices, such as the BetterBack device, have been designed to decrease pain and improve posture, however, there is limited evidence to support these claims. Methods: 18 subjects participated in a two-week study during which they wore the BetterBack device for 15 minutes per day for 14 days. Posture was analyzed using the PostureScreen® and SitScreen® mobile application. Participants rated pain with a Visual Analog Scale (VAS) each day before and after wearing the device. Results: Average daily pain scores for all subjects after wearing the device were significantly less (p<0.05) than before wearing the device, with a mean decrease of 1.56 cm on the VAS. Pain scores were decreased on day 15 compared to initial scores, but these changes were not significant. Several postural measurements showed significant mean improvements, including the initial sitting thorax angle and forward head shift off of vertical in standing. The trunk thigh angle while sitting with the device on also improved. Conclusion: The BetterBack device provided effective lumbar support immediately reducing LBP, but did not carryover without the device. Significant improvements were found in some of the postural measurements, however, the interpretation of the effectiveness of the device is limited by a small effect size.

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“…Nineteen percent of these had used opioids, 10% took non-steroidal anti-inflammatory drugs (NSAIDs), 8.5% took muscle relaxants, and 7% used gabapentinoids. Antidepressants and hypnotics were used by 18% and 5%, respectively [12]. This survey showed that analgesic polypharmacy is common, though guidelines on the use of medications for LBP highlight the small benefit from these therapies.…”

Section: Overview Of Pharmacological Options For Low Back Painmentioning

confidence: 98%

“…Opioids are the most commonly used prescription medication for chronic LBP, with one in five Americans using them to treat pain and a majority using them chronically [12]. Similar to all other analgesic medications, there is limited evidence in the form • Epidural S(+) ketamine enhanced analgesic effects of steroids and local anesthetics and reduced disability in patients with LBP and radicular pain • Subanesthetic intravenous ketamine (mean dose 0.9 mg kg −1 ) in severe refractory pain states reduced pain for over 3 weeks • Epidural ketamine may be associated with neurotoxicity of controlled trials supporting opioid use beyond 4 months, though long-term use is associated with an increased risk of abuse and overdose.…”

Section: Opioidsmentioning

confidence: 99%

Current and future pharmacological agents for the treatment of back pain

Bhatia

Engle

Cohen

2020

Expert Opinion on Pharmacotherapy

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Prescription Medication Use Among Community-Based U.S. Adults With Chronic Low Back Pain: A Cross-Sectional Population Based Study

Cited by 57 publications

References 56 publications

Patterns of gabapentin and pregabalin use and misuse: Results of a population‐based cohort study in France

Patterns of gabapentin and pregabalin use and misuse: Results of a population‐based cohort study in France

Does BetterBack Lumbar Support and Posture Trainer Decrease Back Pain and Improve Posture?

Current and future pharmacological agents for the treatment of back pain

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