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Table 5 Factors Associated with Medical Management during Patient Visits in which Low Back Pain was the Primary Reason for Seeking Care, 2003–2004 (n = 710)*

From: The epidemiology and medical management of low back pain during ambulatory medical care visits in the United States

  Medical Management
  Exercise Counseling Any Patient Counseling Narcotic Analgesic NSAID Any Drug
Characteristic OR† 95% CI OR† 95% CI OR† 95% CI OR† 95% CI OR† 95% CI
Patient age, y           
<25 0.53 0.15 – 1.90 0.64 0.27 – 1.53 0.35 0.11 – 1.11 0.93 0.44·1.94 0.19 0.08 – 0.50
25–44 1.00 ... 1.00 ... 1.00 ... 1.00 ... 1.00 ...
45–64 1.20 0.66 – 2.19 1.08 0.66 – 1.75 0.80 0.47 – 1.36 0.64 0.39·1.06 0.63 0.36 – 1.09
≥65 0.93 0.47 – 1.83 0.67 0.38 – 1.19 0.42 0.21 – 0.84 0.73 0.44·1.20 0.77 0.38 – 1.56
Patient sex           
Female 1.00 ... 1.00 ... 1.00 ... 1.00 ... 1.00 ...
Male 0.85 0.52 – 1.38 0.91 0.62 – 1.36 0.90 0.59 – 1.39 0.99 0.68·1.45 0.76 0.50 – 1.14
Patient race           
White 1.00 ... 1.00 ... 1.00 ... 1.00 ... 1.00 ...
Non-White 0.66 0.23 – 1.89 0.49 0.25 – 0.96 0.91 0.42 – 2.01 1.30 0.60·2.84 3.54 1.40 – 8.97
Patient ethnicity           
Non-Hispanic 1.00 ... 1.00 ... 1.00 ... 1.00 ... 1.00 ...
Hispanic 1.45 0.77 – 2.77 1.45 0.77 – 2.77 0.30 0.11 – 0.76 1.12 0.53·2.36 1.78 0.73 – 4.36
Geographic region           
Northeast 1.00 ... 1.00 ... 1.00 ... 1.00 ... 1.00 ...
Midwest 0.33 0.14 – 0.78 0.29 0.14 – 0.60 1.18 0.43 – 3.24 2.05 0.93 – 4.49 2.00 0.67 – 5.97
South 0.27 0.13 – 0.56 0.36 0.17 – 0.74 1.16 0.50 – 2.72 1.81 0.84 – 3.90 2.23 0.98 – 5.08
West 0.59 0.26 – 1.34 0.45 0.22 – 0.93 1.56 0.63 – 3.84 1.45 0.67 – 3.14 1.85 0.75 – 4.56
MSA status           
MSA 1.00 ... 1.00 ... 1.00 ... 1.00 ... 1.00 ...
Non-MSA 0.45 0.21 – 0.96 0.77 0.38 – 1.53 1.96 1.06 – 3.63 0.90 0.40 – 2.07 2.90 0.64 – 13.08
Chronicity           
Acute (initial visit) 1.00 ... 1.00 ... 1.00 ... 1.00 ... 1.00 ...
Chronic (follow-up visit) 0.87 0.48 – 1.59 1.16 0.72 – 1.87 1.54 0.87 – 2.75 0.56 0.37 – 0.86 0.35 0.19 – 0.64
IPA etiology           
No 1.00 ... 1.00 ... 1.00 ... 1.00 ... 1.00 ...
Yes 2.34 1.49 – 3.68 2.38 1.50 – 3.77 0.74 0.44 – 1.27 1.19 0.83 – 1.73 0.62 0.36 – 1.08
PCP status           
Non-PCP or unknown 1.00 ... 1.00 ... 1.00 ... 1.00 ... 1.00 ...
PCP 1.59 0.67 – 3.76 1.10 0.56 – 2.17 1.38 0.72 – 2.67 1.62 1.05 – 2.49 1.98 1.19 – 3.28
Type of physician           
Doctor of Medicine 1.00 ... 1.00 ... 1.00 ... 1.00 ... 1.00 ...
Doctor of Osteopathy 1.53 0.80 – 2.92 1.02 0.46 – 2.26 0.70 0.31 – 1.58 0.43 0.24 – 0.76 0.44 0.18 – 1.11
Physician specialty           
Family (general) medicine 0.30 0.12 – 0.74 0.71 0.32 – 1.59 0.99 0.46 – 2.12 1.52 0.79 – 2.92 2.38 1.06 – 5.35
Internal medicine 0.15 0.05 – 0.40 0.42 0.13 – 1.32 0.63 0.25 – 1.62 0.68 0.28 – 1.69 0.73 0.28 – 1.87
Neurology 0.24 0.06 – 0.94 0.50 0.18 – 1.39 0.88 0.38 – 2.05 0.94 0.43 – 2.04 0.86 0.38 – 1.98
Orthopedics 1.55 0.59 – 4.05 1.01 0.40 – 2.55 0.81 0.33 – 2.00 0.97 0.39 – 2.40 0.45 0.16 – 1.31
All other specialties 1.00 ... 1.00 ... 1.00 ... 1.00 ... 1.00 ...
Shared physician care           
No or unknown 1.00 ... 1.00 ... 1.00 ... 1.00 ... 1.00 ...
Yes 1.13 0.62 – 2.08 1.08 0.62 – 1.87 1.61 0.95 – 2.76 1.28 0.70 – 2.36 1.02 0.60 – 1.75
  1. Abbreviations: CI, confidence interval; IPA, injury, poisoning, or adverse effect of medical treatment; MSA, metropolitan statistical area; NSAID, nonsteroidal anti-inflammatory drug; OR, odds ratio; PCP, primary care physician.
  2. *Only initial visits for acute problems or follow-up visits for chronic problems were included.
  3. †Adjusted for all variables shown.