Patient and Provider Characteristics Associated with the Receipt of Image-Guided Interventions for Low Back Pain

Area of Science:

• Medical research
• Health equity
• Pain management

Background:

• Low back pain (LBP) is a leading cause of disability.
• Racial disparities in nonpharmacologic LBP treatments are documented.
• Conservative image-guided interventions are common before surgery for LBP.

Purpose of the Study:

• To investigate racial disparities in LBP treatment.
• To analyze the impact of patient-provider discussions on treatment plans.
• To compare image-guided intervention rates between White/non-Hispanic and underrepresented minority LBP patients.

Main Methods:

• Retrospective analysis of adult LBP patients in a Utah healthcare system.
• Compared frequency of image-guided interventions within 1 year of diagnosis.
• Examined secondary outcomes including physical therapy, surgery, and time to treatment.

Main Results:

• White/non-Hispanic patients received image-guided interventions more often (12.5% vs. 7.2%) despite higher pain in underrepresented minorities.
• Underrepresented minorities saw generalists/APPs more frequently but had lower specialist referral completion rates (60.4% vs. 77.7%).
• Referrals to specialists took longer for underrepresented minorities (54 vs. 27.5 days).

Conclusions:

• Underrepresented minority patients with LBP receive fewer image-guided interventions than White patients.
• Incomplete specialist referrals and evaluations are key barriers to intervention for minorities.
• Provider bias was not supported as a factor; systematic barriers may exist.