Understanding Primary Care Physicians' Treatment of Chronic Low ...

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LCA Results Conditional Probability of Treatment Use, Given Class Membership (Column) Treatment Overall Class 1 Sample Multimodal / n=381 Aggressive (14%) n=54 Class 2 Psychosocial / Non-opioid (48%) n=181 Class 3 Low Action (38%) n=146 1) Discuss emotional issues 57% 79% 73% 31% 2) Order further diagnostic testing 63% 77% 61% 61% 3) Perform functional assessment 60% 81% 72% 38% 4) Refer for physical therapy 50% 50% 58% 40% 5) Refer for a mental health evaluation 15% 17% 28% 0% 6)Rf Refer to pain clinic/specialist lii/ ilit 56% 71% 61% 44% 7) Question about drugs/alcohol 62% 85% 84% 30% 8) Tylenol 3 regularly/at higher dose 17% 29% 8% 21% 9) Change to different schedule 3 opioid 18% 53% 0% 24% 10) Treat w/ short-acting schedule 2 opioid 14% 41% 0% 19% 11) Treat with long-acting schedule 2 opioid id 11% 40% 0% 10% on fixed basis
Latent Classes • Multimodal l/ Aggressive treatment (MA) ‐ 14% – Endorsed every option at the overall sample probability or greater – Medication and psychosocial options – Also question about drug/alcohol use at high rate • Psychosocial / Non‐opioid (PNO) – 48% – Endorsed non‐opioid treatments at higher‐than‐average rates – Most likely to refer to physical therapy or mental health evaluation – Almost no endorsement of opioid therapies • Low action (LA) – 38% – About as likely as average to utilize opioid therapies – Less likely l to utilize psychosocial ltherapies
Page 1 and 2: Understanding Primary Care Physicia
Page 3 and 4: Chronic Pain Treatment • Prevalen
Page 5 and 6: Efficacy of Opioids for Chronic Pai
Page 7 and 8: Social Factors and Chronic Pain •
Page 9 and 10: Biopsychosocial model • Pain has
Page 11 and 12: Current Study • The current study
Page 13 and 14: Photonovella • Bt Between‐subje
Page 15 and 16: Images from Questionnaire
Page 17 and 18: Sample • Questionnaires sent to n
Page 19 and 20: Outcome Measure Please indicate how
Page 21 and 22: Latent Class Analysis • Creates c
Page 23: LCA Model Selection • We consider
Page 27 and 28: Moving Physicians into Multimodal T
Page 29 and 30: Measures - Physician Traits • Phy
Page 31 and 32: Measures - Pain Attitudes • Posit
Page 33 and 34: Measures - Perception of the Patien
Page 35 and 36: Measures - Resources • I have ade
Page 37 and 38: Analysis • Bivariate models (line
Page 39 and 40: Discussion • Compared to the psyc
Page 41 and 42: Discussion • Compared to the low

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