4 new studies highlight advances in collaborative care model for spinal disorders

Sherry McAllister, DC -

Four new studies indicate that the U.S. healthcare system is progressing toward a patient-centered, comprehensive and collaborative care model.

This care model incorporates chiropractic care as a drug-free approach to managing spinal disorders and general health concerns.

The studies also reflect the continued shift in the healthcare industry toward conservative, non-invasive pain management. As such, a growing number of physicians and medical organizations are recognizing how highly trained and skilled doctors of chiropractic (DC) play an important role in integrated care teams, specifically as it relates to the non-opioid management of back, neck and headache pain.

Those four recent studies are:
1. “Chiropractic Integration into Private Sector Medical Facilities: A Multisite Qualitative Case Study.” The Journal of Alternative and Complementary Medicine (July 2018).

Researchers evaluated a diverse group of U.S. private sector medical facilities that had integrated chiropractic care in nine clinics. DCs were sought to take an evidence-based approach to patient care, work collaboratively within a multidisciplinary team and engage in interprofessional case management. Markers for clinic success included: patient clinical outcomes, patient satisfaction, provider productivity and cost offset. Based on these markers, facility stakeholders, including clinicians, support staff, administrators and patients, reported high satisfaction with the care provided by DCs.

2. “Effect of Usual Medical Care Plus Chiropractic Care vs Usual Medical Care Alone on Pain and Disability Among U.S. Service Members with Low Back Pain: A Comparative Effectiveness Clinical Trial.” JAMA Network Open (May 2018).

Patients who received collaborative care that included chiropractic manipulation integrated with usual medical care reported improvement in low back pain intensity and disability compared with those who received standard medical care (medication, physical therapy, pain management) alone. This study was the largest randomized clinical trial in chiropractic research in the United States to date. It took place over four years, from September 2012 to February 2016, and involved 750 active-duty U.S. military personnel at three sites across the country.

3. “Chiropractic Integrated Care Pathway for Low Back Pain in Veterans: Results of a Delphi Consensus Process.” Journal of Manipulative and Physiological Therapeutics (February 2018).

This National Institutes of Health-funded study focused on developing an integrated care pathway for DCs, primary care providers and mental health professionals who manage veterans with low back pain (with or without mental health comorbidity) within Department of Veterans Affairs (VA) healthcare facilities. The care pathway included a new standardized approach to interdisciplinary referral to chiropractic services and for chiropractic case management in a VA medical center setting. As such, chiropractic care is now a tier 1 integrative pain treatment modality that may be incorporated into a Veteran’s patient-centered care plan.

4. “Be Good, Communicate, and Collaborate: A Qualitative Analysis of Stakeholder Perspectives on Adding a Chiropractor to the Multidisciplinary Rehabilitation Team.” Chiropractic & Manual Therapies (June 2018).

This study supports the integration of a DC into a multidisciplinary rehabilitation team. Researchers interviewed 60 participants as part of a study designed to provide an expanded view of the qualities that DCs might bring to integrated healthcare settings. Suggestions for leadership strategies and professional attributes the chiropractic profession needs to consider were included, such as patient-centeredness (being respectful, responsive and inclusive of the patient’s values), interprofessional qualities (teamwork, resourcefulness) and personality fit.

A more than century-old recognized healthcare profession
As a result of patient need, the opioid epidemic and value-based models of care, this research about the role of chiropractic in collaborative care could not come at a better time. Today, all 50 states, along with the District of Columbia, Puerto Rico and U.S. Virgin Islands officially recognize chiropractic as a healthcare profession. In addition to the U.S., chiropractic is also recognized around the globe with the World Federation of Chiropractic representing 92 countries in which chiropractic is practiced.

About the author:
Sherry McAllister, DC, M.S. (Ed) CCSP, serves as the executive vice president for the Foundation for Chiropractic Progress (www.F4CP.org), a U.S. not-for-profit organization educating the public about the benefits of chiropractic. Dr. McAllister earned her Master’s in Education from the University of California East Bay and is a graduate of Palmer College of Chiropractic West, where she taught as an associate professor. She has served as a qualified medical examiner, expert chiropractic witness for the State of California, and has been in private practice in San Jose since 1996.

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