■治疗腰痛(LBP)通常涉及药物,非药理学,和介入治疗;一种方法是针灸疗法,这是安全的,有效,和成本效益。如何在LBP的疼痛护理方案中使用针灸尚未得到广泛研究。
■为了记录2010年至2019年在大量LBP患者中报销的针灸趋势,关注人口统计,社会经济,以及与针灸使用和非药理学相关的临床特征,药理学,和使用针灸的患者使用的介入治疗。
■这项横断面研究将美国成年人的保险索赔纳入了一个未识别的数据库。研究样本包括2010年至2019年诊断为LBP的患者。数据在2023年9月至2024年6月之间进行了分析。
■2010年至2019年期间,包括电针使用在内的报销针灸利用率的变化,这涉及到针灸针的电刺激。协变量包括年龄,性别,种族和民族,收入,教育程度,区域,和慢性LBP指标。次要分析跟踪其他非药物治疗(例如,物理治疗,脊椎按摩护理),药物治疗(如,阿片类药物,gabapentinoids),和介入治疗(例如,硬膜外类固醇注射)。
■总样本包括6840497名患有LBP的成年人(平均[SD]年龄,54.6[17.8]岁;3916766名女性[57.3%];802579名西班牙裔[11.7%],258087非西班牙裔亚洲人[3.8%],804975非西班牙裔黑人[11.8%],4974856非西班牙裔白人[72.7%])。总的来说,106485人(1.6%)有1个或更多的针灸索赔,而61503(0.9%)有1个或更多的电针索赔。针灸利用率持续增长,从2010年的0.9%提高到2019年的1.6%;电针率相对稳定。女性患者(男性:比值比[OR],0.68;99%CI,0.67-0.70),亚洲(或,3.26;99%CI,3.18-3.35),居住在太平洋地区(新英格兰:或,0.26;99%CI,0.25-0.28),收入超过10万美元(收入低于4万美元:或,0.59;99%CI,0.57-0.61),受过大学教育(高中或以下:或,0.32;99%CI,0.27-0.35),和慢性LBP(或,2.39;99%CI,2.35-2.43)更有可能利用针灸。针灸使用者更有可能从事其他非药物疼痛护理,如物理治疗(39.2%;99%CI,38.9%-39.5%vs29.3%;99%CI,29.3%-29.3%),使用处方药的可能性较小,包括阿片类药物(41.4%;99%CI,41.1%-41.8%vs52.5%;99%CI,52.4%-52.5%),与非用户相比。
■在这项横断面研究中,我们发现,LBP患者的针灸使用率很少,但随着时间的推移,针灸使用率会增加.人口统计,社会经济,和临床特征与针灸使用有关,针灸使用者更有可能使用其他非药物治疗,而不太可能使用药物治疗。
UNASSIGNED: Treating low back pain (LBP) often involves a combination of pharmacologic, nonpharmacologic, and interventional treatments; one approach is acupuncture therapy, which is safe, effective, and cost-effective. How acupuncture is used within pain care regimens for LBP has not been widely studied.
UNASSIGNED: To document trends in reimbursed acupuncture between 2010 and 2019 among a large sample of patients with LBP, focusing on demographic, socioeconomic, and clinical characteristics associated with acupuncture use and the nonpharmacologic, pharmacologic, and interventional treatments used by patients who utilize acupuncture.
UNASSIGNED: This cross-sectional study included insurance claims of US adults in a deidentified database. The study sample included patients diagnosed with LBP between 2010 and 2019. Data were analyzed between September 2023 and June 2024.
UNASSIGNED: Changes in rates of reimbursed acupuncture utilization between 2010 and 2019, including electroacupuncture use, which involves the electrical stimulation of acupuncture needles. Covariates included age, sex, race and ethnicity, income, educational attainment, region, and a chronic LBP indicator. Secondary analyses tracked other nonpharmacologic treatments (eg, physical therapy, chiropractic care), pharmacologic treatments (eg, opioids, gabapentinoids), and interventional treatments (eg, epidural steroid injections).
UNASSIGNED: The total sample included 6 840 497 adults with LBP (mean [SD] age, 54.6 [17.8] years; 3 916 766 female [57.3%]; 802 579 Hispanic [11.7%], 258 087 non-Hispanic Asian [3.8%], 804 975 non-Hispanic Black [11.8%], 4 974 856 non-Hispanic White [72.7%]). Overall, 106 485 (1.6%) had 1 or more acupuncture claim, while 61 503 (0.9%) had 1 or more electroacupuncture claim. The rate of acupuncture utilization increased consistently, from 0.9% in 2010 to 1.6% in 2019; electroacupuncture rates were relatively stable. Patients who were female (male: odds ratio [OR], 0.68; 99% CI, 0.67-0.70), Asian (OR, 3.26; 99% CI, 3.18-3.35), residing in the Pacific region (New England: OR, 0.26; 99% CI, 0.25-0.28), earning incomes of over $100 000 (incomes less than $40 000: OR, 0.59; 99% CI, 0.57-0.61), college educated (high school or less: OR, 0.32; 99% CI, 0.27-0.35), and with chronic LBP (OR, 2.39; 99% CI, 2.35-2.43) were more likely to utilize acupuncture. Acupuncture users were more likely to engage in other nonpharmacologic pain care like physical therapy (39.2%; 99% CI, 38.9%-39.5% vs 29.3%; 99% CI, 29.3%-29.3%) and less likely to utilize prescription drugs, including opioids (41.4%; 99% CI, 41.1%-41.8% vs 52.5%; 99% CI, 52.4%-52.5%), compared with nonusers.
UNASSIGNED: In this cross-sectional study, we found that acupuncture utilization among patients with LBP was rare but increased over time. Demographic, socioeconomic, and clinical characteristics were associated with acupuncture utilization, and acupuncture users were more likely to utilize other nonpharmacologic treatments and less likely to utilize pharmacologic treatments.