{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T09:51:46Z","timestamp":1753869106997,"version":"3.41.2"},"reference-count":26,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,8,2]],"date-time":"2024-08-02T00:00:00Z","timestamp":1722556800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European Journal of Pain"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Low back pain (LBP) is a leading reason for opioid use and a closer examination of opioid use and productivity losses among these patients is needed. We identify opioid use trajectories using a group\u2010based trajectory model (GBTM) and estimate productivity losses across the trajectories.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients diagnosed with LBP in Swedish specialty care between 2011 and 2015, between the ages of 20 and 60, were included. Two GBTMs were estimated on monthly opioid use (converted to oral morphine equivalents) during the two 12\u2010month periods preceding and following diagnosis. Productivity losses were estimated using the human\u2010capital approach.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 147,035 patients were included. The mean age at diagnosis was 43\u2009years of age and 49% of the patients were male. A qualitative assessment of the identified groups in the GBTM models was made based on the patterns of opioid use. We chose three pre\u2010diagnosis groups characterized as \u2018Pre\u2010low\u2019 (<jats:italic>N<\/jats:italic>\u2009=\u2009109,492), \u2018Pre\u2010increase\u2019 (<jats:italic>N<\/jats:italic>\u2009=\u200927,336) and \u2018Pre\u2010high\u2019 (<jats:italic>N<\/jats:italic>\u2009=\u200910,207). Similarly, four post\u2010diagnosis groups were chosen and characterized as \u2018Post\u2010low\u2019 (<jats:italic>N<\/jats:italic>\u2009=\u200973,287), \u2018Post\u2010decrease\u2019 (<jats:italic>N<\/jats:italic>\u2009=\u200939,446), \u2018Post\u2010moderate\u2019 (<jats:italic>N<\/jats:italic>\u2009=\u200920,001) and \u2018Post\u2010high\u2019 (<jats:italic>N<\/jats:italic>\u2009=\u200913,595). Only 50% of the patients in the \u2018Pre\u2010high\u2019 group were in the \u2018Post\u2010high\u2019 group. The total productivity losses by the pre\u2010diagnosis groups were more than 2.7\u2009billion Euros over the total 6\u2010year study period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study highlights how patients with LBP and high use of opioids are highly correlated before and after diagnosis. Patients with high use of opioids also exhibit high work absence and productivity losses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance Statement<\/jats:title><jats:p>This was the first study to estimate trajectories of opioids in the two time periods before and after a diagnosis of low back pain. For the first time, productivity losses were also estimated across the identified opioid use trajectories.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ejp.4706","type":"journal-article","created":{"date-parts":[[2024,8,2]],"date-time":"2024-08-02T08:59:05Z","timestamp":1722589145000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Trajectories of opioid use among patients with low back pain: Association to work absence"],"prefix":"10.1002","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3954-8914","authenticated-orcid":false,"given":"Johan Liseth","family":"Hansen","sequence":"first","affiliation":[{"name":"University of Oslo  Oslo Norway"},{"name":"Quantify Research  Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Knut Reidar","family":"Wangen","sequence":"additional","affiliation":[{"name":"University of Oslo  Oslo Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,8,2]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0227966"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.4088\/PCC.11m01326"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/add.15071"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000002539"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1080\/00016470510030698"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2665-9913(23)00098-X"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000000516"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1515\/sjpain-2021-0212"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40273-023-01269-4"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1515\/sjpain-2022-0137"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.2147\/DDDT.S342409"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40273-014-0132-3"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000001500"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12874-022-01622-9"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.4159\/9780674041318"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejp.2163"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-018-5742-6"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2021.750193"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.15620\/cdc:122556"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/j.1532-2149.2011.00018.x"},{"key":"e_1_2_8_22_1","unstructured":"The Association for the publication of the Norwegian Drug Handbook. (2019).Tabell 1: Ekvianalgetiske doser av opioidanalgetika og virkningstid [equianalgetic doses of opioid analgesics and time of effect].https:\/\/www.legemiddelhandboka.no\/L20.2\/Tabeller"},{"key":"e_1_2_8_23_1","unstructured":"The Danish Health Data Authority. (2020).Forbruget af opioider er aftaget efter \u00f8get fokus p\u00e5 brugen.https:\/\/sundhedsdatastyrelsen.dk\/\u2010\/media\/sds\/filer\/find\u2010tal\u2010og\u2010analyser\/laegemidler\/smertestillende\u2010medicin\/forbrug_af_opioider_2019.pdf"},{"key":"e_1_2_8_24_1","unstructured":"The Dental and Pharmaceutical Benefits Agency. 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