Evidence map›Paper›PMID 36306465›Full record

ArticleJournal of complementary & integrative medicine2023

A cross-sectional survey exploring clinician perceptions of a novel Medicaid back pain policy.

Catherine J Livingston, Mary Gray, Kate LaForge, Esther K Choo

Open access · greenAbstract read
In one paragraph

Article in Journal of complementary & integrative medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.7field-weighted citation impact, top 29% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 4 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 1 institution in 1 country.

Catherine J LivingstonDepartment of Emergency Medicine, Oregon Health & Science University, OR, USA.ORCID https://orcid.org/0000-0002-6190-6565
Mary GrayComagine Health, OR, USA.
Kate LaForgeComagine Health, OR, USA.
Esther K ChooDepartment of Emergency Medicine, Oregon Health & Science University, OR, USA.
Oregon Health & Science University · US

Funding

Implementation, Outcomes, and Cost of a Novel Medicaid Policy to Reduce Opioids for Back PainR01DA044284 · NIDA · OREGON HEALTH & SCIENCE UNIVERSITY · PI CHOO, ESTHER K · 2018 to 2022
$3.2M
NIDA NIH HHS R01 DA044284
6 · The paper itself

Abstract

objectivesOregon Medicaid (Oregon Health Plan, or OHP) implemented an innovative policy in 2016 that increased coverage of evidence-based non-pharmacologic therapies (NPT, including physical therapy, massage, chiropractic, and acupuncture) while restricting opioids, epidural steroid injections, and surgeries. The objective of this study was to compare the perspectives of clinicians who see back pain patients and can prescribe pharmacologic therapies and/or refer to NPTs and clinicians who directly provide NPT therapies affected by the policy.

methodsA cross-sectional online survey was administered to Oregon prescribing clinicians and NPT clinicians between December 2019 and February 2020. The survey was completed by 107 prescribing clinicians and 83 NPT clinicians.

resultsPrescribing clinicians and NPT clinicians had only moderate levels of familiarity with core elements of the policy. Prescribing clinicians had higher levels of frustration caring for OHP patients with back pain than NPT clinicians (83 vs. 34%, p<0.001) and were less confident in their ability to provide effective care (73 vs. 85%, p = .025). Eighty-six percent of prescribing clinicians and 83% of NPT clinicians thought active NPT treatments were effective; 74 and 70% thought passive NPT treatments were effective. Forty percent of prescribing clinicians and 25% of NPT clinicians (p<0.001) thought medically-light therapies were effective, while 29% of prescribing clinicians and 10% of NPT clinicians thought medically-intensive treatments were effective (p=0.001). Prescribing clinicians thought increased access to NPTs improved outcomes, while opinions were less consistent on the impact of restricting opioid prescribing.

conclusionsPrescribing clinicians and NPT clinicians had varying perspectives of a Medicaid coverage policy to increase evidence-based back pain care. Understanding these perspectives is important for contextualizing policy effectiveness.

Indexed as

Analgesics, OpioidMedicaidBack PainCross-Sectional StudiesHumansPractice Patterns, Physicians'United StatesAnalgesics, Opioidback painhealthcare policiesMedicaidnon-pharmacological treatmentopioids

Identifiers

PMID36306465
PMCPMC11302735
OpenAlexW4307583785

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.