Differences in Function and Comorbidities Between Older Adult Users and Nonusers of Chiropractic and Osteopathic Manipulation: A Cross-sectional Analysis of the 2012 National Health Interview Survey

Forte, Mary; Maiers, Michele

doi:10.1016/j.jmpt.2018.12.003

Cited by 4 publications

(2 citation statements)

References 34 publications

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“…A surprising finding was the high rate of ED visits for individuals with LBP seeing Chiros first. In a secondary analysis of 2012 National Health Interview Survey data, Forte and Maiers [ 39 ] found one in four individuals 65 years or older who saw chiropractors reported at least one ED visit in the prior 12 months. Interestingly, the ED visit rate between those that reported having manipulation was comparable to controls (no manipulation).…”

Section: Discussionmentioning

confidence: 99%

Where to start? A two stage residual inclusion approach to estimating influence of the initial provider on health care utilization and costs for low back pain in the US

Harwood

Pines

Andrilla

et al. 2022

BMC Health Serv Res

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Background Diagnostic testing and treatment recommendations can vary when medical care is sought by individuals for low back pain (LBP), leading to variation in quality and costs of care. We examine how the first provider seen by an individual at initial diagnosis of LBP influences downstream utilization and costs. Methods Using national private health insurance claims data, individuals age 18 or older were retrospectively assigned to cohorts based on the first provider seen at the index date of LBP diagnosis. Exclusion criteria included individuals with a diagnosis of LBP or any serious medical conditions or an opioid prescription recorded in the 6 months prior to the index date. Outcome measures included use of imaging, back surgery rates, hospitalization rates, emergency department visits, early- and long-term opioid use, and costs (out-of-pocket and total costs of care) twelve months post-index date. We used a two-stage residual inclusion (2SRI) estimation approach comparing copay for the initial provider visit and differential distance as the instrumental variable to reduce selection bias in the choice of first provider, controlling for demographics. Results Among 3,799,593 individuals, cost and utilization varied considerably based on the first provider seen by the patient. Copay and differential distance provided similar results, with copay preserving a greater sample size. The frequency of early opioid prescription was significantly lower when care began with an acupuncturist or chiropractor, and highest for those who began with an emergency medicine physician or advanced practice registered nurse (APRN). Long-term opioid prescriptions were low across most providers except physical medicine and rehabilitation physicians and APRNs. The frequency and time to serious illness varied little across providers. Total cost of care was lowest when starting with a chiropractor ($5093) or primary care physician ($5660), and highest when starting with an orthopedist ($9434) or acupuncturist ($9205). Conclusion The first provider seen by individuals with LBP was associated with large differences in health care utilization, opioid prescriptions, and cost while there were no differences in delays in diagnosis of serious illness.

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Section: Discussionmentioning

confidence: 99%

Where to start? A two stage residual inclusion approach to estimating influence of the initial provider on health care utilization and costs for low back pain in the US

Harwood

Pines

Andrilla

et al. 2022

BMC Health Serv Res

View full text Add to dashboard Cite

show abstract

“…Spine-related pain and disability are common among older adults (1,2) and impact the overall health, physical function, social interactions, and quality of life of persons in their later years (3,4). Back and neck pain are leading contributors to years lived with disability among older adults (5).…”

Section: Introductionmentioning

confidence: 99%

“Like Peanut Butter and Jelly”: A Qualitative Study of Chiropractic Care and Home Exercise Among Older Adults With Spinal Disability

Maiers

Salsbury

2022

Arthritis Care & Research

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Objective. A mixed-methods, randomized controlled trial comparing short-and long-term chiropractic care and exercise therapy for spinal disability in older adults found no between-group differences in the primary outcome. However, those who received long-term management reported greater improvement in neck pain, self-efficacy, function, and balance. This nested qualitative study explored participants' perceptions of the benefits and drawbacks of chiropractic care and exercise for spine-related outcomes, with an emphasis on understanding what makes treatment for spine-related problems worthwhile.Methods. Of 171 individual interviews conducted after completing study treatment, 50 participants (25 per treatment group) were randomly selected for this analysis. Qualitative descriptive analysis included dual coding of verbatim transcripts by 2 investigators (MM and SAS), which was further distilled into a consensus-derived codebook of themes and organized using NVIVO software.Results. Participants described trial interventions as complementary to one another for spine-related disability. Chiropractic care was viewed as improving spinal pain and controlling symptoms, while exercise therapy was noted for its long-term impact on self-efficacy and self-management. These older adults considered changes in pain, global sense of improvement, and improved biomechanical function as making treatment worthwhile.Conclusion. Older adults valued nonpharmacologic treatment options that aided them in controlling spine-related symptoms, while empowering them to maintain clinical benefit gained after a course of chiropractic spinal manipulation and exercise. The complementary nature of provider-delivered and active care modalities may be an important consideration when developing care plans. This study underscores the importance of understanding participants' values and experiences when interpreting study results and applying them to practice.The contents of this article are solely the responsibility of the authors and do not necessarily represent the official views of the US Department of Health and Human Services.

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Evidence on the use of alternative substances and therapies in hypertension

Martín-Riobóo,

Turégano-Yedro,

Banegas

2024

Hipertensión y Riesgo Vascular

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Differences in Function and Comorbidities Between Older Adult Users and Nonusers of Chiropractic and Osteopathic Manipulation: A Cross-sectional Analysis of the 2012 National Health Interview Survey

Cited by 4 publications

References 34 publications

Where to start? A two stage residual inclusion approach to estimating influence of the initial provider on health care utilization and costs for low back pain in the US

Where to start? A two stage residual inclusion approach to estimating influence of the initial provider on health care utilization and costs for low back pain in the US

“Like Peanut Butter and Jelly”: A Qualitative Study of Chiropractic Care and Home Exercise Among Older Adults With Spinal Disability

Evidence on the use of alternative substances and therapies in hypertension

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