ArticleBMC health services research2018
Assessing practice pattern differences in the treatment of acute low back pain in the United States Military Health System.
Article in BMC health services research, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04704297 (Trigger Point Injection for Myofascial Pain Syndrome in the Low Back), which is not on this map. Cited by 9 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Trigger Point Injection for Myofascial Pain Syndrome in the Low Back (T-PIMPS): A Randomized Controlled Trial.
Who cites it
9 citing papers in PubMed.
- Prevalence and risk factors of low back pain among Lithuanian national defense volunteer forces.BMC musculoskeletal disorders · 2025Article
- Treatment variability for shoulder pain between physician and non-physician clinicians based on initial setting and specific shoulder diagnosis: a health system analysis.BMC health services research · 2025Observational
- Opioid prescribing and use in the Military Health System: a framework synthesis, FY2016-FY2021.Pain medicine (Malden, Mass.) · 2023Article
- Where to start? A two stage residual inclusion approach to estimating influence of the initial provider on health care utilization and costs for low back pain in the US.BMC health services research · 2022Article
- The relationship between capacity and utilization of nonpharmacologic therapies in the US Military Health System.BMC health services research · 2022Article
- Influence of provider type on chronic pain prescribing patterns A systematic review.Journal of the American Association of Nurse Practitioners · 2022Article
- Do nonpharmacological services offset opioids in pain treatment for soldiers?Health services research · 2021Article
- Use of low-value pediatric services in the Military Health System.BMC health services research · 2020Article
- Trends in Use of Acupuncture During Pregnancy for the Military Health System, 2006-2016.Medical acupuncture · 2019Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
Abstract
backgroundAcute low back pain is one of the most common reasons for individuals to seek medical care in the United States. The US Military Health System provides medical care to approximately 9.4 million beneficiaries annually. These patients also routinely suffer from acute low back pain. Within this health system, patients can receive care and treatment from physicians, or physician extenders including physician assistants and nurse practitioners. Given the diversity of provider types and their respective training programs, it would be informative to evaluate variation in care delivery, adherence to clinical guidelines, and differences within the MHS among a complex mix of provider types.
methodsThis study was a retrospective, cross-sectional quantitative analysis that examined variations in treatment between provider types within the Military Health System in 2015 for treatment of acute low back pain using administrative data. In addition to descriptive and summary statistics, binomial logistic regression models were used to assess variation in practice patterns among physicians and mid-level practitioners for prescribing of non-steroidal anti-inflammatory, opioids, plain radiography, computed tomography, and magnetic resonance imaging.
resultsWith regard to prescribing practices, results indicated that the odds of receiving non-steroidal anti-inflammatory prescriptions increased significantly for both physician assistants and nurse practitioners when compared to physicians. For basic radiological referrals, odds increased significantly for ordering plain radiography for physician assistants and nurse practitioners when compared to physicians. For more advanced imaging, odds significantly decreased for ordering computed tomography (CT) and slightly decreased for magnetic resonance for physician assistants, nurse practitioners and physician residents compared to the physician group. Additionally this study discovered differences in the prescribing patterns between provider categories. Both contractors and civilians had higher odds of prescribing opioids compared to active duty providers.
conclusionsAs physician assistants and nurse practitioners continue to gain popularity as physician extenders in the US and in addressing provider shortages for the Military Health System, further research should be conducted to determine what impact, if any, the differences found in this study have on patient outcomes. In addition, provider type warrants further investigation to determine if labor mix and outsourcing decisions within a single payer system impacts health delivery and value based care.
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Registered trials
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