The Relationship of PROMIS Physical Function Scores, Healthcare Resource Utilization, and Charges in Patients Treated for Chronic Mechanical Low Back Pain

Speaker(s)

Hejazi A1, Ye X2, Youssef J3, Moebus C3, Goss B3, Brodke D4, McCormick Z4, Schaecher KL5, Brixner D2, Willis C2
1University of Utah College of Pharmacy, salt lake city, UT, USA, 2University of Utah College of Pharmacy, Salt Lake City, UT, USA, 3Mainstay Medical, San Diego, CA, USA, 4University of Utah School of Medicine, Salt Lake City, UT, USA, 5University of Utah Health Plans, Murray, UT, USA

Presentation Documents

OBJECTIVES:

This study assessed the correlation between healthcare resource utilization (HRU) and Patient-Reported Outcomes Measurement Information System Physical Function (PROMIS-PF) scores and developed a model to predict healthcare charges for patients treated for mechanical chronic lower back pain (CLBP).

METHODS:

This was a retrospective cohort study within a university-based health system. Adult patients diagnosed with CLBP between 2015 through 2020 who were non-surgical candidates were included. PROMIS-PF scores were grouped from Category 0 (lowest physical function) to 3 (highest physical function) and patients were stratified into Low-PF (Category 0-1) or High-PF (2-3) cohorts. Outcomes were compared between cohorts. Incidence rate ratios (IRR) were used to compare HRU. Mixed-effects regression was used to model healthcare charges while controlling for PROMIS-PF scores, comorbidities, and other patient characteristics.

RESULTS:

3,586 patients were included in this study; mean age was 49.9 (SD:17.3) years, 69.3% were Female, and 85.8% were White. The Low-PF cohort (n=898) showed higher rates of inpatient (IRR: 2.3, p<0.001), outpatient (IRR: 1.2, p<0.001), intensive care unit (IRR: 7.6, p=0.002), and emergency department (IRR: 1.9, p<0.001) visits compared to High-PF (n=2,688). Similarly, the Low-PF cohort had higher utilization of opioids (54%) compared to High-PF (37%) (p<0.001). Actual median healthcare charges for Year-1 were highest for Category 0 patients ($14,650 [IQR: 5,506-37,936]) and lowest for Category 3 ($5,450 [IQR: 2,455-13,694]). The predictive model for a base-case scenario (no comorbidities, White, Female, BMI<25) estimated cumulative charges at Year-2 being >2-fold higher for Low-PF patients compared to High-PF ($15,126 [95% CI: $12,953-17,746] vs $7,345 [95% CI: $6,771-7,976]).

CONCLUSIONS:

Significantly higher HRU for Low- vs. High-PF patients with CLBP led to an almost 3-fold increase in actual charges. These data support the use of patient-reported outcomes in the evaluation of new technologies for CLBP to assess clinical benefit and overall charges towards more informed decision-making regarding reimbursement and benefit design.

Code

RWD78

Topic

Methodological & Statistical Research, Patient-Centered Research, Study Approaches

Topic Subcategory

Electronic Medical & Health Records, Patient-reported Outcomes & Quality of Life Outcomes

Disease

Musculoskeletal Disorders (Arthritis, Bone Disorders, Osteoporosis, Other Musculoskeletal), No Additional Disease & Conditions/Specialized Treatment Areas