Management of Back Pain-related Disorders in a Community With Limited Access to Health Care Services: A Description of Integration of Chiropractors as Service Providers

Emary, Peter C.; Brown, Amy L.; Cameron, Douglas F.; Pessoa, Alexander F.; Bolton, John R.

doi:10.1016/j.jmpt.2017.07.011

Cited by 9 publications

(16 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The chiropractic programme at the Langs CHC has been described in detail elsewhere. 15 18 Briefly, this is a partially subsidised, complimentary service that operates on two separate days of the week (for a total of 4 hours per week) and is provided on a rotating basis by a team of between three to four chiropractors. The service is only accessible to patients registered at the CHC and through referral from their GP.…”

Section: Methods and Analysismentioning

confidence: 99%

“…11 Since 2007, a growing number of primary care centres in Canada have reported on their experiences with integration of chiropractic services into chronic pain management. [12][13][14][15][16][17][18][19] Findings from these reports describe Strengths and limitations of this study ► We will link electronic medical records with medical drug claims data from the Institute for Clinical Evaluative Sciences to validate patient opioid prescriptions and dosages. ► Generalised estimating equations will be used to account for hierarchical clustering and to control for differences in confounding factors between our exposure and comparison groups.…”

Section: Introductionmentioning

confidence: 99%

“…Open access improvements in pain intensity and disability and high levels of patient satisfaction; additional outcomes include reductions in physician visits, specialist referrals, advanced imaging and prescribing of opioid and non-opioid analgesics. [12][13][14][15][16][17][18][19] However, these studies [12][13][14][15][16][17][18][19] employed single cohort, pre-post designs (ie, no comparison groups), thereby preventing a formal assessment of whether chiropractic integration improved chronic pain management compared with standard practice. 20 Comparative assessments of the integration of chiropractic services into primary care settings are sparse, 21 22 and the impact of such integration on prescription opioid use in chronic pain management remains uncertain.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Association of chiropractic integration in an Ontario community health centre with prescription opioid use for chronic non-cancer pain: a mixed methods study protocol

et al. 2021

View full text Add to dashboard Cite

IntroductionEmerging evidence from a number of primary care centres suggests that integration of chiropractic services into chronic pain management is associated with improved clinical outcomes and high patient satisfaction as well as with reductions in physician visits, specialist referrals use of advanced imaging and prescribing of analgesics. However, formal assessments of the integration of chiropractic services into primary care settings are sparse, and the impact of such integration on prescription opioid use in chronic pain management remains uncertain. To help address this knowledge gap, we will conduct a mixed methods health service evaluation of an integrated chiropractic back pain programme in an urban community health centre in Ontario, Canada. This centre provides services to vulnerable populations with high unemployment rates, multiple comorbidities and musculoskeletal disorders that are commonly managed with prescription opioids.Methods and analysisWe will use a sequential explanatory mixed methods design, which consists of a quantitative phase followed by a qualitative phase. In the quantitative phase, we will conduct a retrospective chart review and evaluate whether receipt of chiropractic services is associated with reduced opioid use among patients already prescribed opioid therapy for chronic pain. We will measure opioid prescriptions (ie, opioid fills, number of refills and dosages) by reviewing electronic medical records of recipients and non-recipients of chiropractic services between 1 January 2014 and 31 December 2020 and use multivariable regression analysis to examine the association. In the qualitative phase, we will conduct in-depth, one-on-one interviews of patients and their general practitioners to explore perceptions of chiropractic integration and its impact on opioid use.Ethics and disseminationThis study was approved by the Hamilton Integrated Research Ethics Board at McMaster University (approval number 2021–10930). The results will be disseminated via peer-reviewed publications, conference presentations and in-person or webinar presentations to community members and healthcare professionals.

show abstract

Section: Methods and Analysismentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Association of chiropractic integration in an Ontario community health centre with prescription opioid use for chronic non-cancer pain: a mixed methods study protocol

et al. 2021

View full text Add to dashboard Cite

show abstract

“…High levels of patient satisfaction with chiropractic treatment have been consistently reported ( 7 – 10 ). For example, the average score on the 14-item chiropractic satisfaction questionnaire (administered using a 7-category response scale (very poor, poor, fair, good, very good, excellent, the best) in a sample of 486 patients of 44 chiropractors was in-between excellent and the best ( 8 ).…”

Section: Introductionmentioning

confidence: 99%

Experiences With Chiropractic Care for Patients With Low Back or Neck Pain

Sherbourne

Spritzer²,

Hilton

et al. 2019

Journal of Patient Experience

View full text Add to dashboard Cite

Background: Musculoskeletal disorders are the second leading cause of disability worldwide. Objective: Examine experiences of chiropractic patients in the United States with chronic low back or neck pain. Method: Observational study of 1853 chronic low back pain and neck pain patients (74% female) who completed an online questionnaire at the 3-month follow-up that included Consumer Assessment of Healthcare Providers and Systems (CAHPS) items assessing their experiences with care. Results: We found similar reports of communication for the chiropractic sample and patients in the 2016 CAHPS National Database, but 85% in the database versus 79% in the chiropractic sample gave the most positive response to the time spent with provider item. More patients in the CAHPS database rated their provider at the top of the scale (8 percentage points). More chiropractic patients reported always getting answers to questions the same day (16 percentage points) and always being seen within 15 minutes of their appointment time (29 percentage points). Conclusions: The positive experiences of patients with chronic back and neck pain are supportive of their use of chiropractic care.

show abstract

“…10,11 In common with other professions, a growing number of chiropractic programs are adopting clinical immersion placements (CIPs). [12][13][14][15][16][17][18][19][20][21] CIPs are a form of experiential clerkship characterized by ''hands-on'' community service involvement, which is integrated with the curriculum and designed to encourage social responsibility and active community participation. 22,23 Interest in this educational alternative has arisen from a perceived utility of this approach in fostering communication and interpersonal skills and a philosophy of caring.…”

Section: Introductionmentioning

confidence: 99%

A mixed-method study of chiropractic student clinical immersion placements in nonmetropolitan Western Australia: Influence on student experience, professional attributes, and practice destination

Amorin-Woods¹,

Losco²,

Leach³

2019

Journal of Chiropractic Education

View full text Add to dashboard Cite

Objective: To explore the influence of nonmetropolitan clinical immersion placements (CIPs) on undergraduate chiropractic student experience, professional attributes, and practice destination. Methods: Students enrolled in an Australian undergraduate chiropractic program were invited to complete a service experience questionnaire and an open-ended reflective feedback form following a nonmetropolitan CIP (Part A). Online searches were performed to gather data on graduate practice location (Part B). Results: Sixty-four students participated in Part A. All agreed that the placement was educational and should be retained in the program. Students agreed that the placement enhanced respect for individuals and awareness of others in need, highlighted the importance of respect for all people, improved empathy for the disadvantaged, and provided an opportunity to improve communication skills. Most indicated that they were more likely to practice in a country setting as a result of their placement, with those participating in a country placement more likely to practice in nonmetropolitan regions after graduation. Conclusion: Many chiropractic programs around the world are adopting CIPs. This study is the 1st to investigate the possible influence of nonmetropolitan CIPs on the development of desirable attributes in Australian chiropractic students. It also discusses the potential influence of nonmetropolitan CIPs on future practice location decisions. These results support the utility of CIPs to help meet the educational objectives of chiropractic programs and possibly address the maldistribution of the chiropractic workforce in Australia.

show abstract

Management of Back Pain-related Disorders in a Community With Limited Access to Health Care Services: A Description of Integration of Chiropractors as Service Providers

Cited by 9 publications

References 30 publications

Association of chiropractic integration in an Ontario community health centre with prescription opioid use for chronic non-cancer pain: a mixed methods study protocol

Association of chiropractic integration in an Ontario community health centre with prescription opioid use for chronic non-cancer pain: a mixed methods study protocol

Experiences With Chiropractic Care for Patients With Low Back or Neck Pain

A mixed-method study of chiropractic student clinical immersion placements in nonmetropolitan Western Australia: Influence on student experience, professional attributes, and practice destination

Contact Info

Product

Resources

About