Treatment Patterns and Population Characteristics of Nonpharmacologic Management of Chronic Pain in the United States’ Medicare Population

Treatment Patterns and Population Characteristics of Nonpharmacologic Management of Chronic Pain in the United States’ Medicare Population: A Scoping Review

A ChiroSecure Research Update

Abstract: This scoping review aimed to systematically map and characterize the existing studies about the receipt of noninvasive, nonpharmacologic pain therapies by Medicare beneficiaries.

Discussion: The final review included 33 studies. Of these, 24 were quantitative, 7 were qualitative, and 2 were mixed-methods studies. Of 32 studies that focused on Medicare beneficiaries, 10 did not specify the Medicare type, and all but one of the remaining studies were restricted to fee-for-service enrollees. Back and neck pain and arthritis were the most commonly studied pain types. Chiropractic care (n=19) and physical therapy (n=17) appeared frequently among included studies. The frequency and/or duration of nonpharmacologic treatment was mentioned in 13 studies. Trends in the utilization of nonpharmacologic pain therapies were assessed in 6 studies but none of these studies went beyond 2008.

Conclusion: This scoping review found that manipulative therapies, mainly chiropractic, have been the most widely studied approaches for nonpharmacologic pain management in the Medicare population. The review also identified the need for future research that updates trend data and addresses contemporary issues such as rising Medicare Advantage enrollment and promulgation of practice guidelines for pain management.

Reference: Erum Choudry, BDS and others, Treatment Patterns and Population Characteristics of Nonpharmacologic Management of Chronic Pain in the United States’ Medicare Population: A Scoping Review, Innovation in Aging, 2023;, igad085, https://doi.org/10.1093/geroni/igad085