A Model of Integrative Care for Low-Back Pain

Abstract

It was feasible for a multidisciplinary, outpatient IC team to deliver coordinated, individualized intervention to patients with subacute LBP. Results showed a promising trend for benefit of treating patients with persistent LBP with this IC model, and warrant evaluation in a full-scale study.

Establishing an Integrative Medicine Program Within an Academic Health Center: Essential Considerations

“…Lastly, as initially envisioned, the financial sustainability of the center was expected to rely on a combination of clinical revenues, educational/training revenues, philanthropic contributions as well as research income and overhead. As envisioned in our model, the establishment of, and ongoing clinical activities based at the OCC have catalyzed novel research initiatives, 23 which in turn have supported clinical infrastructure and enhanced visibility and credibility of the clinical team. For example, initial positive outcomes of migraine patients referred from a HMS-affiliated hospital headache program led to a collaborative pilot trial evaluating a mind-body program offered at the OCC for managing migraine symptoms.…”

The Evolution of Complementary and Alternative Medicine (CAM) in the USA over the Last 20 Years

“…A consortium of philanthropists called the Bravewell Collaborative also supported an Institute of Medicine (IOM) runing meeting and report [29]. Other official studies included the ‘White House Commission on Complementary and Alternative Medicine' chaired by former NIH employee James Gordon [30], and another NIH sponsored IOM study on IM research chaired by academician and physician Harold Sox, who was editor of the prominent mainstream journal Annals of Internal Medicine [31]. Among the IOM report's recommendations was the following: ‘Studies show that patients frequently do not limit themselves to a single modality of care - they do not see complementary and alternative medicine (CAM) and conventional medicine as being mutually exclusive - and this pattern will probably continue and may even expand as evidence of therapies' effectiveness accumulate.…”

“…Among the IOM report's recommendations was the following: ‘Studies show that patients frequently do not limit themselves to a single modality of care - they do not see complementary and alternative medicine (CAM) and conventional medicine as being mutually exclusive - and this pattern will probably continue and may even expand as evidence of therapies' effectiveness accumulate. Therefore, it is important to understand how CAM and conventional medical treatments (and providers) interact with each other and to study models of how the two kinds of treatments can be provided in coordinated ways' [29,31]. …”

“…In a recent comprehensive review of models of integrative practice (where CAM and conventional medicine are administered in a coordinated, evidence-based manner), only 4 studies were found [45]. Eisenberg has recently published a model of integrative medicine training in back pain that illustrates what may be needed to produce such models [31]. Furthermore, in an age of rising costs, a major question is ‘What are the costs of CAM and/or integrative care?'…”

An integrative review of complementary and alternative medicine use for back pain: a focus on prevalence, reasons for use, influential factors, self-perceived effectiveness, and communication

“…Despite lacking evidence base, CAM has become widely available internationally and has become popular in recent years in Australia and United States among many other countries [4,5]. Complementary and alternative medicine and its use have become the topic of significant international public health investigation [6,7], and the use of CAM in the treatment of chronic health conditions such as ''back pain'' [8] has become a significant health service issue.…”