Masahiro Iwakura, Atsuyoshi Kawagoshi, Yutaka Furukawa, Keiyu Sugawara, Toshiki Wakabayashi, Tsutomu Sato, Masahiko Wakasa
Association of health literacy with short-term postoperative outcomes in older adult patients with abdominal tumors undergoing surgery and perioperative rehabilitation program: A prospective cohort study
Journal of geriatric oncology
aims study identify prognostic factors associated health care outcomes patients musculoskeletal conditions primary care determine whether characteristics associated choice care modify treatment effects directaccess physical therapistled pathway addition general practitioner gpled care compared gpled care alone secondary analysis 2parallelarm cluster randomized controlled trial involving general practices united kingdom conducted practices randomized continue offering gpled care also offer directaccess physical therapistled pathway data adults musculoskeletal conditions completed 6month followup questionnaire analyzed outcomes included physical health opioid prescription selfreported health care utilization 6 months treatment effect modifiers selected priori associations observational studies multivariable regression models identified potential prognostic factors interaction analysis tested potential treatment effect modifiers analysis 767 participants indicated baseline pain selfefficacy pain severity low back pain statistically predicted outcomes 6 months higher pain selfefficacy scores baseline associated improved physical health scores reduced opioid prescription less health care utilization higher bodily pain baseline low back pain associated worse physical health scores increased opioid prescription main interaction analyses reveal patients age level education duration symptoms musculoskeletal presentation influenced response treatment visual trends suggested older age group proceeded fewer opioid prescriptions utilized less health care offered direct access physical therapy patients musculoskeletal conditions lower levels pain selfefficacy higher pain severity presenting low back pain less favorable clinical health care outcomes primary care prespecified characteristics modify treatment effect offer directaccess physical therapistled pathway compared gpled care patients musculoskeletal conditions receiving primary care form directaccess physical therapistled gpled care lower levels selfefficacy higher pain severity low back pain likely less favorable prognosis age duration symptoms explored potential patient characteristics modify treatment response directaccess physical therapistled model care