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Open Access Research article

Back pain in seniors: the Back pain Outcomes using Longitudinal Data (BOLD) cohort baseline data

Jeffrey G Jarvik11023*, Bryan A Comstock34, Patrick J Heagerty34, Judith A Turner356, Sean D Sullivan11, Xu Shi4, David R Nerenz8, Srdjan S Nedeljkovic7, Larry Kessler103, Kathryn James13, Janna L Friedly36, Brian W Bresnahan13, Zoya Bauer13, Andrew L Avins9 and Richard A Deyo12

Author Affiliations

1 Department of Radiology, University of Washington, 325 Ninth Ave., Box 359728, Seattle, WA 98104-2499, USA

2 Department of Neurological Surgery, University of Washington, Seattle, WA, USA

3 Comparative Effectiveness, Cost and Outcomes Research Center, University of Washington, 325 Ninth Ave., Box 359728, Seattle, WA 98104-2499, USA

4 Department of Biostatistics, University of Washington, Seattle, WA, USA

5 Department of Psychiatry & Behavioral Sciences, University of Washington, Seattle, WA, USA

6 Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA

7 Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women’s Hospital, Boston, MA, USA

8 Neuroscience Institute, Henry Ford Hospital, Detroit, MI, USA

9 Division of Research, Northern California Kaiser-Permanente, Oakland, CA, USA

10 Department of Health Services, University of Washington, Seattle, WA, USA

11 Department of Pharmacy, University of Washington, Seattle, WA, USA

12 Departments of Family Medicine, Internal Medicine, and Public Health and Preventive Medicine, and the Center for Research in Occupational and Environmental Toxicology Oregon Health and Science University, Portland, OR, USA

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BMC Musculoskeletal Disorders 2014, 15:134  doi:10.1186/1471-2474-15-134

Published: 23 April 2014

Abstract

Background

Back pain represents a substantial burden globally, ranking first in a recent assessment among causes of years lived with disability. Though back pain is widely studied among working age adults, there are gaps with respect to basic descriptive epidemiology among seniors, especially in the United States. Our goal was to describe how pain, function and health-related quality of life vary by demographic and geographic factors among seniors presenting to primary care providers with new episodes of care for back pain.

Methods

We examined baseline data from the Back pain Outcomes using Longitudinal Data (BOLD) registry, the largest inception cohort to date of seniors presenting to a primary care provider for back pain. The sample included 5,239 patients ≥ 65 years old with a new primary care visit for back pain at three integrated health systems (Northern California Kaiser-Permanente, Henry Ford Health System [Detroit], and Harvard Vanguard Medical Associates [Boston]). We examined differences in patient characteristics across healthcare sites and associations of patient sociodemographic and clinical characteristics with baseline patient-reported measures of pain, function, and health-related quality of life.

Results

Patients differed across sites in demographic and other characteristics. The Detroit site had more African-American patients (50%) compared with the other sites (7-8%). The Boston site had more college graduates (68%) compared with Detroit (20%). Female sex, lower educational status, African-American race, and older age were associated with worse functional disability as measured by the Roland-Morris Disability Questionnaire. Except for age, these factors were also associated with worse pain.

Conclusions

Baseline pain and functional impairment varied substantially with a number of factors in the BOLD cohort. Healthcare site was an important factor. After controlling for healthcare site, lower education, female sex, African-American race, and older age were associated with worse physical disability and all of these factors except age were associated with worse pain.

Trial registration

Clinical Trials.gov NCT01776242; Registration date: June 13, 2012.