Patients with low back pain (LBP) and comorbid depression or anxiety may have greater healthcare utilization, according to a study presented at the 2019 American Academy of Pain Medicine annual meeting held in Denver, Colorado, March 6-10.

The electronic health records of consecutive patients with LBP (n=428,401; 58% women; age, 52.4±19.4) who were treated between January 2010 and April 2018 were examined. To assess healthcare utilization, the investigators assessed the number of opioid prescriptions, use of advanced imaging, number of epidural steroid injections (ESI), surgery, emergency department visits, and hospitalizations.

In this cohort, 12.9% and 13.8% of patients had a diagnosis of depression and anxiety, respectively, at baseline. Patients with vs without depression were more likely to be hospitalized (odds ratio [OR], 1.31), to receive an opioid prescription (OR, 1.72), to undergo advanced imaging (OR, 1.20), to visit the emergency department (OR, 1.72), to have undergone surgery (OR, 0.74), or to receive an ESI (OR, 1.33). Patients with vs without anxiety were more likely to visit the emergency department (OR, 1.47), to receive an opioid prescription (OR, 1.46) or an ESI (OR, 1.13), and were less likely to have surgery (OR, 0.59).

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“More effective interventions should be investigated for [patients with LBP and depression/anxiety],” concluded the study authors.

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Bailes A, Navlani R, Marroquin OC, et al. Anxiety and depression are associated with increased health care utilization in low back pain. Presented at: the 2019 American Academy of Pain Medicine annual meeting; March 6-10, 2019; Denver, CO. Abstract 127.