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Relationship Between Self-reported Low-back Pain Severity and Other Patient-reported Outcomes: Results From an Observational Study

Sadosky, Alesia B. PhD MPH, MBA*; Taylor-Stokes, Gavin MBA; Lobosco, Steve MA; Pike, James M.Phil; Ross, Edgar MD

Journal of Spinal Disorders & Techniques:
doi: 10.1097/BSD.0b013e3182296c15
Original Articles

Study Design: A cross-sectional observational study of physicians and patients with chronic low-back pain (CLBP) in the United States.

Objective: To evaluate the association of patient-reported CLBP severity with other patient-reported outcomes.

Summary of Background Data: Appropriate management of patients with CLBP can be enhanced by understanding how patients perceive the severity of their CLBP.

Methods: Data were from the 2009 Adelphi Disease Specific Programme. Patients reported the severity of their CLBP condition by answering the question Please rate how your chronic lower back pain condition is today with responses of mild, moderate, and severe. Patient-reported severity was evaluated with respect to scores on standard patient self-report measures of pain, pain interference, health status, functional disability, work productivity, and questions addressing satisfaction with medications for treating CLBP.

Results: Of 1860 subjects in the CLBP database, 1363 (73.3%) agreed to complete the survey. This sample was similarly distributed between males (49%) and females (51%), with mean age 54.8 years: 52% were employed at least part-time. CLBP severity was rated as mild, moderate and severe by 28.6%, 53.3%, and 18.2% of patients, respectively. With increasing CLBP severity, significant differences were observed in increased pain (P<0.0001), pain interference with function (P<0.0001), and impairment while working due to CLBP (P<0.01), mainly due to presenteeism. Increased work impairment resulted in higher costs related to lost work productivity; annual lost productivity costs were estimated at $7080, $16,616, and $25,032 per patient for mild, moderate, and severe CLBP, respectively (P<0.0001 for pairwise comparisons). Patient satisfaction with pain-related medication was inversely associated with CLBP severity.

Conclusions: The association between patient-reported CLBP severity and other patient-reported outcomes demonstrates that in the clinical setting, patient-reported CLBP severity provides an accurate and suitable indicator of patient-reported health status. This indicator may be useful for guiding management strategies for CLBP patients.

Author Information

*Pfizer Inc., Global Health Economics and Outcomes Research, New York, NY

Adelphi Real World, Adelphi Mill, Bollington, Macclesfield, Cheshire, UK

Pain Management Center, Brigham and Women’s Hospital, Boston, MA

Supported by Pfizer Inc. E.R. was not financially compensated for his collaboration. G.T-S., S.L., and J.P. are employees of Adelphi, who were paid consultants to Pfizer in connection with the conduct of this study and the development of the article.

The authors did not receive funding for research on which our article is based from any of the following organizations: National Institutes of Health (NIH), Wellcome Trust, Howard Hughes Medical Institute (HHMI).

The authors declare no conflict of interest.

Reprints: Alesia B. Sadosky, PhD, MPH, MBA, Pfizer Inc., Global Health Economics and Outcomes Research, 235 East 42nd Street, MS 235/9/2, New York, NY 10017 (e-mail:

Received March 3, 2011

Accepted June 3, 2011

© 2013 Lippincott Williams & Wilkins, Inc.