Table 2:
Characteristics of Medicare beneficiaries with chronic low back pain in trajectory groups of physical therapy use
| No or little PT use (Group 1) | Delayed and increasing PT use (Group 2) | Early and declining PT use (Group 3) | |
|---|---|---|---|
| Age ≥65 years, % | 339,445 (70.3) | 36,582 (80.9) | 68,593 (86.1) |
| Mean age (SD), years | 67.6 (12.6) | 69.6 (10.7) | 70.8 (10.1) |
| Female sex, % | 304,820 (63.1) | 30,834 (68.2) | 54,053 (67.9) |
| Race, % | |||
| Non-Hispanic White | 385,736 (79.9) | 37,027 (81.9) | 64,954 (81.5) |
| Black or African-American | 47,863 (9.9) | 3,338 (7.4) | 4,815 (6.0) |
| Asian or Pacific Islander | 9,730 (2.0) | 1,258 (2.8) | 3,469 (4.4) |
| Hispanic (any race) | 27,972 (5.8) | 2,447 (5.4) | 3,877 (4.9) |
| American Indian or Alaska Native | 3,274 (0.7) | 199 (0.4) | 264 (0.33) |
| Other | 2,752 (0.6) | 303 (0.7) | 721 (0.91) |
| Unknown | 5,511 (1.1) | 662 (1.5) | 1,557 (2.0) |
| Had low-income subsidy, % | 193,160 (40.0) | 11,646 (25.8) | 17,872 (22.4) |
| Reason for current Medicare entitlement, % | |||
| Old age and survivors insurance | 339,448 (70.3) | 36,583 (80.9) | 68,593 (86.1) |
| Disability insurance benefits | 141,982 (29.4) | 8,590 (19.0) | 11,013 (13.8) |
| End-stage renal disease | 799 (0.2) | 35 (0.1) | 34 (0.04) |
| Had Dual Enrollment, % | 175,607 (36.4) | 10,845 (24.0) | 16,608 (20.9) |
| U.S. Region, % | |||
| Midwest | 127,414 (26.4) | 9,695 (21.4) | 14,661 (18.4) |
| Northeast | 77,084 (16.0) | 8,993 (19.9) | 19,616 (24.6) |
| South | 198,950 (41.2) | 15,898 (35.2) | 24,401 (30.6) |
| West | 78,887 (16.3) | 10,581 (23.4) | 20,863 (26.2) |
| Other | 503 (0.1) | 67 (0.2) | 116 (0.15) |
| Metropolitan Status, % | |||
| Metropolitan | 353,005 (73.1) | 37,208 (82.3) | 67,693 (85.0) |
| Rural | 42,270 (8.8) | 2,336 (5.2) | 3,469 (4.35) |
| Urban | 87,361 (18.1) | 5,656 (12.5) | 8,416 (10.6) |
| Medical conditions diagnosed | |||
| Opioid use disorder | 45,257 (9.4) | 2,981 (6.6) | 3,405 (4.3) |
| Non-back musculoskeletal pain | 255,754 (53.0) | 26,418 (58.4) | 48,024 (60.3) |
| Falls | 27,588 (5.7) | 2,463 (5.5) | 5,006 (6.3) |
| Fractures | 21,336 (4.4) | 2,060 (4.6) | 4,452 (5.6) |
| Surgeries | 17,871 (3.7) | 2,122 (4.7) | 5,725 (7.2) |
| Tobacco use disorder | 43,755 (9.1) | 2,382 (5.3) | 3,000 (3.8) |
| Alcohol use disorder | 7,400 (1.5) | 493 (1.1) | 776 (1.0) |
| Non-opioid drug use disorder | 12,580 (2.6) | 728 (1.6) | 1,054 (1.3) |
| Mental health disorder | 156,082 (32.3) | 13,350 (29.5) | 21,022 (26.4) |
| Diabetes (type 1 or 2) | 137,362 (28.5) | 12,106 (26.8) | 20,797 (26.1) |
| Cardiovascular disease | 102,363 (21.2) | 9,297 (20.6) | 15,798 (19.83) |
| Chronic obstructive pulmonary disease | 79,932 (16.6) | 5,828 (12.9) | 87,34 (11.0) |
| Asthma | 41,787 (8.7) | 4,326 (9.6) | 7,163 (9.0) |
| Hypertension | 308,973 (64.0) | 28,813 (63.7) | 49,263 (61.8) |
| Chronic kidney disease | 54,688 (11.3) | 4,671 (10.3) | 7,628 (9.6) |
| Drug overdose | 3,463 (0.7) | 238 (0.5) | 330 (0.4) |
| Dementia | 12,775 (2.6) | 827 (1.8) | 1,633 (2.1) |
| Gagne comorbidity score | |||
| <0 or 0 | 235,023 (48.7) | 22,825 (50.4) | 41,385 (52.0) |
| 1 | 98,686 (20.4) | 9,486 (21.0) | 16,491 (20.7) |
| 2 to 3 | 93,737 (19.4) | 8,588 (19.0) | 14,595 (18.3) |
| 4 or more | 55,392 (11.5) | 4,335 (9.6) | 7,186 (9.0) |
| Died during follow-up, % | 11,105 (2.3) | 226 (0.5) | 797 (1.0) |
NOTE: PT = physical therapy, SD = standard deviation
Non-back musculoskeletal pain includes neck pain, fibromyalgia, and osteoarthritis; Non-opioid drug use disorder includes cannabis, sedative, cocaine and other use disorders; Mental health disorder includes schizophrenia, bipolar disorder, mood disorder, major depressive disorder, anxiety disorder, and psychotic disorder; Cardiovascular disease includes ischemic heart disease and heart failure
P-values for group comparisons were all <0.0001 except for falls (P=0.0041)