ArticleHealth services research2021
The association between the supply of select nonpharmacologic providers for pain and use of nonpharmacologic pain management services and initial opioid prescribing patterns for Medicare beneficiaries with persistent musculoskeletal pain.
Article in Health services research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
What it found
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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.
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Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it, 20 citations in OpenAlex.
- CDC Clinical Practice Guideline for Prescribing Opioids for Pain - United States, 2022.MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports · 2022Guideline
- Can Patient-centered Education and Pain Management Delivered by Coaches Improve Pain Outcomes After Orthopaedic Trauma? A Randomized Trial.Clinical orthopaedics and related research · 2024Trial
- Integrated nurse care management to reduce pain interference for primary care patients in rural communities: results from a pilot study.Pain medicine (Malden, Mass.) · 2026Article
- Rates and predictors of opioid deprescribing after fracture: A retrospective study of Medicare fee-for-service claims.Journal of the American Geriatrics Society · 2025Article
- Pain management and social functioning limitations among adults with chronic pain by diabetes status: National Health Interview Survey, United States, 2019-2020.Primary care diabetes · 2025Article
- Is low-value care for persistent musculoskeletal pain more common in rural than urban areas? A scoping review.BMC health services research · 2025Article
- Trends in Utilization and Cost of Nonpharmacological Pain Therapies in the United States Under Medicare Part B, 2000-2022.Journal of integrative and complementary medicine · 2024Article
- Article
- Association of Opioid Use Disorder Diagnosis With Use of Physical Therapy and Chiropractic Care Among Chronic Low Back Pain Patients: A Group-Based Trajectory Analysis.The journal of pain · 2024Article
- Inequitable access to nonpharmacologic pain treatment providers among cancer-free U.S. adults.Preventive medicine · 2024Article
- Self-Reported Pain Treatment Practices Among U.S. and Canadian Adults: Findings From a Population Survey.Innovation in aging · 2023Article
- Article
- Trends in the Use of Opioids vs Nonpharmacologic Treatments in Adults With Pain, 2011-2019.JAMA network open · 2022Article
- Broadband internet subscription rates and opioid prescribing via telemedicine during the COVID-19 pandemic.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2022Article
- Incident Functional Limitations Among Community-Dwelling Adults Using Opioids: A Retrospective Cohort Study Using a Propensity Analysis with the Health and Retirement Study.Drugs & aging · 2022Article
- The relationship between capacity and utilization of nonpharmacologic therapies in the US Military Health System.BMC health services research · 2022Article
- Association between chiropractic care and use of prescription opioids among older medicare beneficiaries with spinal pain: a retrospective observational study.Chiropractic & manual therapies · 2022Observational
- 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
- The association between the supply of select nonpharmacologic providers for pain and use of nonpharmacologic pain management services and initial opioid prescribing patterns for Medicare beneficiaries with persistent musculoskeletal pain.Health services research · 2021Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 2 countries.
Funding
Abstract
objectiveTo test the relationship between the supply of select nonpharmacologic providers (physical therapy (PT) and mental health (MH)) and use of nonpharmacologic services among older adults with a persistent musculoskeletal pain (MSP) episode. DATA SOURCES/STUDY
settingClaims data from a 5 percent random sample of Medicare beneficiaries enrolled fee-for-service (2007-2014) and the Area Health Resource File (AHRF). STUDY
designThis retrospective study used generalized estimating equations to estimate the association between the county nonpharmacologic provider supply and individual service use with opioid prescriptions filled during Phase 1 (first three months of an episode) and Phase 2 (three months following Phase 1). DATA COLLECTION/EXTRACTION
methodsWe identified beneficiaries (>65 years) with ≥2 MSP diagnoses ≥90 days apart and no opioid prescription six months before the first pain diagnosis (N = 69 456). Beneficiaries' county characteristics were assigned using the AHRF. PRINCIPAL
findingsAbout 13.9 percent of beneficiaries used PT, 1.8 percent used MH services, and 10.7 percent had an opioid prescription during the first three months of a persistent MSP episode. An additional MH provider/10 000 people/county [aOR: 0.97, 95% CI: 0.96-0.98] and PT/10 000 people/county [aOR: 0.98, 95% CI: 0.97-1.00] was associated with lower odds of filling an opioid prescription in Phase 1. An additional MH provider/10 000 people/county [aOR: 0.97, 95% CI: 0.96-0.98] and PT use in Phase 1 [aOR: 0.62, 95% CI: 0.58-0.67] were associated with lower odds of filling an opioid prescription in Phase 2. The associations between the supply of providers and nonpharmacologic service use in Phase 1 and Phase 1 opioid prescriptions significantly differed by metropolitan and rural counties (P-value: .019).
conclusionsLimited access to nonpharmacologic services is associated with opioid prescriptions at the onset of a persistent MSP episode. Initiating PT at the onset of an episode may reduce future opioid use. Strategies for engaging beneficiaries in nonpharmacologic services should be tailored for metropolitan and rural counties.
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Registered trials
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