ArticleMedical care2020
The Association Between the Supply of Nonpharmacologic Providers, Use of Nonpharmacologic Pain Treatments, and High-risk Opioid Prescription Patterns Among Medicare Beneficiaries With Persistent Musculoskeletal Pain.
Article in Medical care, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 17 citations in OpenAlex.
- Predictors and Clinical Outcomes of Long-Term Opioid Therapy in Older Adults: A Systematic Review.Pharmacotherapy · 2026Pooled it
- Baseline sample characteristics for the BackInAction pragmatic trial of acupuncture for chronic low back pain in older adults.Contemporary clinical trials · 2025Trial
- Efficacy and Safety of Transcutaneous Acupoint Electrical Stimulation in the Treatment of Cervical Spondylosis: A Multicenter Randomized Open-Labeled Controlled Clinical Study.Pain research & management · 2025Trial
- Pain, comorbidities, and clinical decision-making: conceptualization, development, and pilot testing of the Pain in Aging, Educational Assessment of Need instrument.Frontiers in pain research (Lausanne, Switzerland) · 2024Article
- Treatment Patterns and Population Characteristics of Nonpharmacological Management of Chronic Pain in the United States' Medicare Population: A Scoping Review.Innovation in aging · 2023Article
- Accuracy and validity of reported opioid prescription days' supply.Pharmacoepidemiology and drug safety · 2022Article
- Trends in the Use of Opioids vs Nonpharmacologic Treatments in Adults With Pain, 2011-2019.JAMA network open · 2022Article
- Role of Rehabilitation in Opioid Tapering: A Scoping Review.Physiotherapy Canada. Physiotherapie Canada · 2022Article
- Claims-based measures of prescription opioid utilization: A practical guide for researchers.Drug and alcohol dependence · 2021Review
- Back and neck pain: in support of routine delivery of non-pharmacologic treatments as a way to improve individual and population health.Translational research : the journal of laboratory and clinical medicine · 2021Review
- Misalignment of Stakeholder Incentives in the Opioid Crisis.International journal of environmental research and public health · 2020Review
- Physical therapy and opioid use for musculoskeletal pain management: competitors or companions?Pain reportsReview
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 at 2 institutions in 1 country.
Funding
Abstract
backgroundOpioids are prescribed more frequently than nonpharmacologic treatments for persistent musculoskeletal pain (MSP). We estimate the association between the supply of physical therapy (PT) and mental health (MH) providers and early nonpharmacologic service use with high-risk opioid prescriptions among Medicare beneficiaries with persistent MSP. RESEARCH
designWe retrospectively studied Medicare beneficiaries (>65 y) enrolled in Fee-for-Service and Part D (2007-2014) with a new persistent MSP episode and no opioid prescription during the prior 6 months. Independent variables were nonpharmacologic provider supply per capita and early nonpharmacologic service use (any use during first 3 mo). One year outcomes were long-term opioid use (LTOU) (≥90 days' supply) and high daily dose (HDD) (≥50 mg morphine equivalent). We used multinomial regression and generalized estimating equations and present adjusted odds ratios (aORs).
resultsAbout 2.4% of beneficiaries had LTOU; 11.9% had HDD. The supply of MH providers was not associated with LTOU and HDD. Each additional PT/10,000 people/county was associated with greater odds of LTOU [aOR: 1.06; 95% confidence interval (CI), 1.01-1.11). Early MH use was associated with lower odds of a low-risk opioid use (aOR: 0.81; 95% CI, 0.68-0.96), but greater odds of LTOU (aOR: 1.93; 95% CI, 1.28-2.90). Among beneficiaries with an opioid prescription, early PT was associated with lower odds of LTOU (aOR: 0.75; 95% CI, 0.64-0.89), but greater odds of HDD (aOR: 1.25; 95% CI, 1.15-1.36).
conclusionsThe benefits of nonpharmacologic services on opioid use may be limited. Research on effective delivery of nonpharmacologic services to reduce high-risk opioid use for older adults with MSP is needed.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.