Background and Aims: Chronic low back pain (CLBP) is a leading cause of disability globally, with prevalence and severity likely to rise with an aging population.  Current treatments have demonstrated only modest benefits. The aim of this study was to understand how an increase in disease severity impacts patient treatment.
Methods: Data were drawn from the Adelphi CLBP Disease Specific Programme (2018-19), a point-in-time study of physicians who treat CLBP and their patients in France, Germany, Italy, Spain & UK. Physicians classified patients as currently having mild, moderate or severe disease severity and provided information on prescribed drug therapy and non-pharmacological treatments. Descriptive statistics were reported. 
Results: Data was available for 3967 patients: 34% had mild (n=1356), 50% moderate (n=1996) and 16% severe CLBP (n=615).  74% patients received at least one prescribed drug for their CLBP (62% of mild; 79% of moderate; 82% of severe patients). Opioids (59%), NSAIDs (54%) and other analgesics, e.g. paracetamol (32%) were the most frequently prescribed drugs, and opioid use increased as severity worsened (43% of mild; 62% of moderate, 78% of severe patients). Overall, 42% of patients were using a non-pharmacological treatment in addition to their prescribed CLBP drug(s) (38% of mild; 51% of moderate; 51% of severe patients). For all patients the most popular treatments were: physiotherapy (62%), fitness/exercise (62%) and weight loss (46%).
Conclusions:  Increasing opioid use, despite increased use of non-pharmacological therapies in moderate-severe CLBP patients, indicates likely sub-optimal treatment with existing management strategies.

CURRENT TREATMENT PATTERNS AMONG PATIENTS IN EUROPE WITH CHRONIC LOW BACK PAIN: ANALYSIS OF REAL-WORLD DATA