TY - JOUR
T1 - Integrating a Multidisciplinary Pain Team and Chiropractic Care in a Community Health Center
T2 - An Observational Study of Managing Chronic Spinal Pain
AU - Prater, Christopher
AU - Tepe, Melissa
AU - Battaglia, Patrick
N1 - Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Logan University has funded this study, specifically through a small grant for participant incentives.
Funding Information:
The authors would like to acknowledge all participants in the study, the study site, Affinia Healthcare, and the funding source, Logan University. The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Logan University has funded this study, specifically through a small grant for participant incentives.
Publisher Copyright:
© The Author(s) 2020.
PY - 2020
Y1 - 2020
N2 - Background: Chronic spinal pain is one of the most common diseases in the United States. Underserved patients are most affected, and disproportionately may use opioid medications as they lack access to other therapies. It is therefore important to develop systems to treat spinal pain within the primary medical home. Methods: We designed a prospective observational pilot study at a community health center to measure the effectiveness of two interventions among an underserved population: a multidisciplinary pain team and chiropractic care. Study outcomes were pain and functional disability measured by the Pain Disability Questionnaire (PDQ), and reduction of opioid dose at baseline and 6-12 months. Multivariate linear regression was used to determine associating factors for change in PDQ scores. Results: Thirty-five individuals completed baseline and follow-up PDQs from August 2018 to May 2020. Overall, the mean baseline PDQ was 92.4 +/− 6.1 and the mean follow-up PDQ was 81.9 +/− 7.7, resulting in a mean improvement of −10.6 (95% CI 1.2 - −22.3, P =.08). Participants in the chiropractic team (mean change −25.0, P =.01) and those completing the study before COVID-19 (mean change = −22.6, P <.01) were found to have significantly greater improvement at follow-up. Conclusion: This observational study within a community health center resulted in improvement in spinal pain and disability with chiropractic care versus a multidisciplinary pain team. Offering similar services in primary care may help to address pain and disability, and hopefully limit external referrals, advanced imaging, and opioid prescriptions.
AB - Background: Chronic spinal pain is one of the most common diseases in the United States. Underserved patients are most affected, and disproportionately may use opioid medications as they lack access to other therapies. It is therefore important to develop systems to treat spinal pain within the primary medical home. Methods: We designed a prospective observational pilot study at a community health center to measure the effectiveness of two interventions among an underserved population: a multidisciplinary pain team and chiropractic care. Study outcomes were pain and functional disability measured by the Pain Disability Questionnaire (PDQ), and reduction of opioid dose at baseline and 6-12 months. Multivariate linear regression was used to determine associating factors for change in PDQ scores. Results: Thirty-five individuals completed baseline and follow-up PDQs from August 2018 to May 2020. Overall, the mean baseline PDQ was 92.4 +/− 6.1 and the mean follow-up PDQ was 81.9 +/− 7.7, resulting in a mean improvement of −10.6 (95% CI 1.2 - −22.3, P =.08). Participants in the chiropractic team (mean change −25.0, P =.01) and those completing the study before COVID-19 (mean change = −22.6, P <.01) were found to have significantly greater improvement at follow-up. Conclusion: This observational study within a community health center resulted in improvement in spinal pain and disability with chiropractic care versus a multidisciplinary pain team. Offering similar services in primary care may help to address pain and disability, and hopefully limit external referrals, advanced imaging, and opioid prescriptions.
KW - integrated care
KW - pain mangement
KW - primary care
KW - spinal pain
KW - underserved communities
UR - http://www.scopus.com/inward/record.url?scp=85090787708&partnerID=8YFLogxK
U2 - 10.1177/2150132720953680
DO - 10.1177/2150132720953680
M3 - Article
C2 - 32909504
AN - SCOPUS:85090787708
VL - 11
JO - Journal of Primary Care and Community Health
JF - Journal of Primary Care and Community Health
SN - 2150-1319
ER -