Cost analysis of chronic pain due to musculoskeletal disorders in Chile

Acute low back pain: Epidemiology, etiology, and prevention: WFNS spine committee recommendations

Objective

Acute low back pain is a highly prevalent condition that poses significant challenges to healthcare systems worldwide. In this manuscript, we present the most current, evidence-based guidelines from the World Federation of Neurosurgical Societies (WFNS) Spine Committee on the epidemiology, etiology, and prevention of acute low back pain (LBP) lasting ≤ 4 weeks.

Methods

We performed a literature review 2012-2022 using the PubMed, Medline, and CENTRAL databases with the keywords "acute low back pain", "acute back pain", "low back pain", "epidemiology", "etiology", "costs", "risk factor", "cultural", "developed", "developing" and "prevention". Systematic screening criteria were applied, resulting in 13 final articles on epidemiology and etiology of LBP, 2 manuscripts on costs, 5 articles on risk factors, and 23 articles on prevention strategies for acute LBP. These were presented at two separate international meetings, where members of the WFNS Spine Committee voted on five final consensus statements presented here.

Results

and Conclusions: There is a high incidence and prevalence of acute LBP, particularly in high-income countries, which is felt to be at least partially due to demographic shifts with an aging population and lifestyle changes including higher rates of obesity and physical inactivity. Acute LBP has a significant impact on quality of life and ability to work, resulting in high direct and indirect costs worldwide. Early diagnosis and appropriate management of acute LBP is recommended to prevent this pain from turning into chronic LBP. The WFNS Spine Committee's recommendations respresent the latest guidelies to help improve patient care for acute LBP worldwide.

Epidemiology of non-oncological high-impact chronic pain in Ecuadorian adults in 2022

Background: There are limited data on non-oncological high-impact chronic pain (HICP) in Ecuador; we report the epidemiological characteristics of HICP. Materials & methods: In this cross-sectional study, we included a random sample of adult individuals who had cell phones. Results & conclusion: The weighted prevalence of HICP was 9.0%: 12.3% for women and 5.6% for men (p = 0.001). HICP was more frequently localized in the lower back and affected the economically active population. Nonsteroidal anti-inflammatory drugs were more commonly used; however, 61% of patients indicated that the effectiveness of their management was low. Overall, HICP had a negative impact on daily life activities. The effectiveness of the current treatment was low and should include an integrated approach.

Integrating Noncancer Chronic Pain to Multimorbidity: A Real Practice Challenge in Chile

Chronic noncancer pain (CNCP) is, and continues to be, a global problem that affects people with multimorbidity. The objective is to comment on the gap in Chile in integrating multimorbidity and CNCP in the real practice context despite the advances in public policies and local evidence revealed. Therefore, a pilot is responding to this problem by implementing an approach to incorporate into a multimorbidity comprehensive approach the assessment of CNCP and adding nonmedical services. It is expected to evaluate its impact on the performance of the health system, as well as on people.

Estimating the direct healthcare utilization and cost of musculoskeletal pain among people with comorbidity: a retrospective electronic health record study

OBJECTIVE

To investigate the impact of pre-existing painful musculoskeletal conditions on healthcare utilization and costs among patients with five common conditions: acute coronary syndrome (ACS), stroke, cancer, dementia and pneumonia.

METHODS

Using primary and secondary care services data from electronic health records, a negative binomial regression model was used to compare resource use while a two-part model was used to compare costs across the five conditions, between those with and without a pre-existing musculoskeletal pain.

RESULTS

The study included 760,792 patients (144,870 with ACS, 121,208 with stroke, 231,702 with cancer, 134,638 with dementia, and 128,374 with pneumonia) in the complete case analysis. Pre-existing musculoskeletal pain had an incident rate ratio of above one for most healthcare resources over the follow-up period and an adjusted additional mean cumulative total healthcare costs per patient of £674.59 (95%CI 570.30 to 778.87) for ACS; £613.34 (95%CI 496.87 to 729.82) for stroke; £459.26 (95%CI 376.60 to 541.91) for cancer; and £766.23 (95%CI 655.06 to 877.39) for dementia over five years after diagnosis; and £200.85 (95%CI 104.16 to 297.55) for pneumonia over one year after diagnosis compared to those without musculoskeletal pain.

CONCLUSION

This study highlights that individuals with painful musculoskeletal conditions have higher healthcare utiliszation and costs than those without painful musculoskeletal conditions. Given the high occurrence of musculoskeletal pain in patients with other conditions, effective management strategies are needed to reduce the burden on healthcare resources.

Focus on the impact of social factors and lifestyle on the disease burden of low back pain: findings from the global burden of disease study 2019

BACKGROUND

Low back pain (LBP) is one of the leading causes of disability worldwide. Differences in social backgrounds and lifestyles in various regions and countries may contribute to the discrepancies in the disease burden of LBP.

METHODS

Based on the GBD 2019, we collected and analyzed numbers and age-standardized rates (ASR) of LBP disability-adjusted life years (DALYs). Temporal trends in ASR were also analyzed using estimated annual percentage change (EAPC). The Age-period-cohort (APC) model was used to estimate age, period and cohort trends in DALYs of LBP. An autoregressive integrated moving average (ARIMA) model was used to forecast DALYs of LBP trends from 2020 to 2035.

RESULTS

The DALYs due to LBP increased from 1990 to 2019. The APC model showed that the risk of DALYs for global LBP increased with age and year and that the risk of DALYs was lower in the later-born cohort than in the earlier-born cohort. The main risk factors which GBD estimates were available for DALYs of LBP include smoking, occupational ergonomic factors and high BMI. It is expected that DALYs of LBP will continue to rise until 2035.

CONCLUSION

From 1990 to 2019, the global disease burden of LBP remained high. It is necessary to pay attention to the influence of social factors and lifestyle on LBP. Focusing on the impact of social factors as well as lifestyle on the prognosis of LBP and targeting interventions may further reduce the disease burden of LBP.