Frank M. Painter

Chiropractic in Global Health and Wellbeing

By Frank M. Painter|July 25, 2018|Wellness|

Chiropractic in Global Health and Wellbeing: A White Paper Describing the Public Health Agenda of the World Federation of Chiropractic

SOURCE: Chiropractic & Manual Therapies 2018 (Jul 17); 26: 26

Michele Maiers, Mustafa Agaoglu, Richard Brown, Christopher Cassirer, Kendrah DaSilva, Reidar P. Lystad, Sarkaw Mohammad, and Jessica J. Wong

Northwestern Health Sciences University,
2501 W 84th St,
Bloomington, MN 55431 USA.

The World Federation of Chiropractic supports the involvement of chiropractors in public health initiatives, particularly as it relates to musculoskeletal health. Three topics within public health have been identified that call for a renewed professional focus. These include healthy ageing; opioid misuse; and women’s, children’s, and adolescents’ health. The World Federation of Chiropractic aims to enable chiropractors to proactively participate in health promotion and prevention activities in these areas, through information dissemination and coordinated partnerships. Importantly, this work will align the chiropractic profession with the priorities of the World Health Organization. Successful engagement will support the role of chiropractors as valued partners within the broader healthcare system and contribute to the health and wellbeing of the communities they serve.

KEYWORDS: Ageing; Chiropractic; Opioid; Public health; children’s health; women’s health

From the Full-Text Article:

Background

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Chiropractic Integration into Private Sector Medical Facilities

By Frank M. Painter|July 23, 2018|Integrative Care|

Chiropractic Integration into Private Sector Medical Facilities:
A Multisite Qualitative Case Study

The Chiro.Org Blog

SOURCE: J Altern Complement Med. 2018 (Jul 17) [Epub]

Anthony J. Lisi, DC, Stacie A. Salsbury, PhD, RN, Elissa J. Twist, DC, MS, and Christine M. Goertz, DC, PhD

Pain Research,
Informatics, Multi-Comorbidities and Education Center,
VA Connecticut Healthcare System,
West Haven, CT.

OBJECTIVES: Chiropractic care may have value in improving patient outcomes and decreasing opioid use, but little is known about the impetus for or process of incorporating these services into conventional medical settings. The purpose of this qualitative study was to describe organizational structures, care processes, and perceived value of chiropractic integration within U.S. private sector medical facilities.

DESIGN: Multisite, comparative organizational case study.

SETTINGS: Nine U.S. private sector medical facilities with on-site chiropractic care, including five hospitals and four clinics.

PARTICIPANTS: One hundred and thirty-five key facility stakeholders including doctors of chiropractic (DCs), non-DC clinicians, support staff, administrators, and patients.

METHODS: Researchers conducted 2-day site visits to all settings. Qualitative data were collected from audio-recorded, semi-structured, role-specified, individual interviews; standardized organizational data tables; and archival document review. A three-member, interdisciplinary team conducted thematic content analysis of verbatim transcripts using an existing conceptual framework and emergent codes.

RESULTS: These nine medical facilities had unique organizational structures and reasons for initiating chiropractic care in their settings. Across sites, DCs were sought to take an evidence-based approach to patient care, work collaboratively within a multidisciplinary team, engage in interprofessional case management, and adopt organizational mission and values. Chiropractic clinics were implemented within existing human resources, physical plant, information technology, and administrative support systems, and often expanded over time to address patient demand. DCs usually were co-located with medical providers and integrated into the collaborative management of patients with musculoskeletal and co-morbid conditions. Delivery of chiropractic services was perceived to have high value among patients, medical providers, and administration. Patient clinical outcomes, patient satisfaction, provider productivity, and cost offset were identified as markers of clinic success.

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Principles in Integrative Chiropractic

By Frank M. Painter|July 17, 2018|Integrative Care|

Principles in Integrative Chiropractic

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SOURCE: J Manipulative Physiol Ther. 2003 (May); 26 (4): 254–272

J.Michael Menke, DC

Program in Internal Medicine,
University of Arizona,
Tucson 85719, USA.

As the public acceptance of chiropractic continues to grow in the United States, [1-3] the private practice chiropractor may find opportunities for formal inclusion in the fast growing integration of complementary and alternative medicine (CAM) into health care delivery. The ability of chiropractors to respond confidently to integration into the overall health care system may be the next step in gaining access to more patients and improving the health care quality.

This necessity for chiropractors to become part of the evolving health care system and still maintain a strong chiropractic identity will be essential, since chiropractic’s value lies in cultivating and delivering the very elements that have made it so high in patient satisfaction: emphasis on biomechanics, manual therapy of the spine, good patient rapport, and strong patient-physician bond. [4, 5] However, there are several barriers to integration: consumer, medical, and chiropractic itself.

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Differences in Pain-related Characteristics Among Younger

By Frank M. Painter|July 15, 2018|Veterans|

Differences in Pain-related Characteristics Among Younger and Older Veterans Receiving Primary Care

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SOURCE: Pain Med. 2002 (Jun); 3 (2): 102–107

M. Carrington Reid, PhD, MD Kimberly T. Crone, PhD John Otis, PhD Robert D. Kerns, PhD

Clinical Epidemiology Unit,
VA Connecticut Healthcare System,
West Haven, Connecticut 06516, USA.

Editorial Comment:

The most disturbing comment in this article was:

Furthermore, the vast majority of respondents reported that the pain causing them the most discomfort had been present for years: Over 90% of all respondents reported a pain duration of greater than 6 months, suggesting that chronic (as opposed to acute) pain conditions are more concerning to veterans receiving primary care.

OBJECTIVES: To characterize the nature of pain complaints among younger and older veterans receiving primary care, and to determine whether characteristics of pain vary as a function of age.

METHODS: Primary care patients at a Veterans Affairs medical center were screened for pain prior to a routine office visit, and those who endorsed a concern about pain were given a self-administered questionnaire that inquired about specific characteristics of their pain including site, duration, frequency, and average intensity of the pain.

RESULTS: Over a 7–month period, 1,290 patients were screened; 641 (50%) reported a concern about pain, and of these, 516 (82%) completed the pain survey. Among younger (age <65 years, N = 191) and older (age > or =65 years, N = 325) respondents, the mean number of sites causing pain was similar (3.6 vs 3.3). Back pain was the most frequently reported site of pain causing the most discomfort among younger (vs older) respondents (31.9% vs 17.8%), whereas older (vs younger) respondents most often endorsed leg pain (32.3% vs 19.9%). The mean duration of pain was not significantly different between older and younger (10.7 vs 10.1 years) respondents; but older (vs younger) respondents were more likely to report constant pain (63.7% vs 46.9%). Using a 0 to 10 numeric rating scale, pain intensity scores were higher among younger (vs older) respondents (5.3 vs 4.3). Rates of prescription pain medication use were not significantly different (52.4% vs 48.0%). Compensation for pain-related disability was more common among younger (vs older) respondents (40.4% vs 19.4%).

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Chiropractic or Osteopathic Manipulation for Children in the United States

By Frank M. Painter|July 11, 2018|Pediatrics|

Chiropractic or Osteopathic Manipulation for Children in the United States: An Analysis of Data from the 2007 National Health Interview Survey

The Chiro.Org Blog

SOURCE: J Altern Complement Med. 2012 (Apr); 18 (4): 347–353

Harrison Ndetan, MSc, MPH, DrPH, Marion Willard Evans, Jr., DC, PhD, MCHES, Cheryl Hawk, DC, PhD, and Clark Walker, BS, MPH

Cheryl Hawk, DC, PhD
Logan College of Chiropractic
Chesterfield, MO 63017

OBJECTIVES: The aim of this study was to describe use of chiropractic and/or osteopathic manipulation by children in the United States along with the specific health conditions for which they sought care.

METHODS: The study was a secondary data analysis of the National Health Interview Survey 2007, Child Alternative Medicine file as well as the Child Core Sample. National population estimates were generated for reported use of chiropractic or osteopathic manipulation (C/OM) by children for specific health conditions. Odds ratios (OR) and 95% confidence intervals (CI) were generated from binary logistic regression models that assessed the likelihood that children of specific characteristics would use this therapy.

RESULTS: National estimates indicated that 2.3 million children (2.3%) in the United States had used C/OM in 2007. C/OM was the most common complementary and alternative medicine procedure. Children aged 12–18 years were more likely to have seen these providers than were younger age groups (OR=3.4 [95% CI, 2.1–5.5]). Homeopathy (1.2%), massage (1.0), and naturopathy (0.3%) were the next most common procedures. The most common complaints were back and neck pain. Other conditions for which children were seen included other musculoskeletal conditions, sinusitis, allergies, and nonmigraine headaches. Racial categories did not differ significantly regarding use of manipulation, but those children with both mother and father in the household were more likely to have used this form of care (OR=1.7 [95% CI, 1.1–2.6]).

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The Effect of Chiropractic Treatment on Infantile Colic

By Frank M. Painter|July 10, 2018|Colic|

The Effect of Chiropractic Treatment on Infantile Colic: Study Protocol for a Single-blind Randomized Controlled Trial

The Chiro.Org Blog

SOURCE: Chiropractic & Manual Therapies 2018 (Jun 7); 26: 17

Lise Vilstrup Holm, Dorte Ejg Jarbøl, Henrik Wulff Christensen, Jens Søndergaard, and Lise Hestbæk

Nordic Institute of Chiropractic and Clinical Biomechanics,
University of Southern Denmark,
Campusvej 55, DK-5230 Odense M, Denmark.

BACKGROUND: Infantile colic is a common condition during early childhood affecting around one of six newborns. The condition is characterized by inconsolable crying and fussing in otherwise healthy and thriving infants. The most used definition is excessive crying for at least three hours a day for at least three days for at least three weeks. The cause of colic is still unknown although many hypotheses and thereby many different treatment modalities have been investigated. Chiropractic care is used increasingly in treatment of infants, including for infantile colic, although the evidence worldwide is sparse. A randomized, controlled trial was designed to evaluate the effect of chiropractic treatment on infantile colic. This paper describes the protocol as well as results from a pilot study examining the acceptability and feasibility of the intervention.

METHOD: The study is designed as a single-blind randomized, controlled trial. The invited families are residents on the Island of Funen and information about the project is distributed from the maternity wards and health visitors. Children at the age of 2–14 weeks with unexplained excessive crying are screened for eligibility and recruited by the primary investigator through home visits. Eligible children are then randomized to chiropractic treatment or control. All children attend in the chiropractor clinic two times a week for two weeks. The parents are unaware of their child’s allocation during the project period. The primary outcome measure is change in daily hours of crying based on the parental diaries.The study intends to include 200 children, and the intervention has, during a pilot study, been found acceptable and feasible among families with newborns.

DISCUSSION: In a single-blind randomized controlled design we will evaluate the effectiveness of chiropractic treatment on infantile colic. The study will contribute to determine the effect of chiropractic treatment on infantile colic in an area where limited evidence exists. Furthermore, the study aims to explore if subgroups of children with suspected musculoskeletal problems will benefit more from the intervention than others. If they obtain better results, this could imply the need for stratified care.

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About Frank M. Painter

Chiropractic in Global Health and Wellbeing

Chiropractic in Global Health and Wellbeing: A White Paper Describing the Public Health Agenda of the World Federation of Chiropractic

Chiropractic Integration into Private Sector Medical Facilities

Chiropractic Integration into Private Sector Medical Facilities: A Multisite Qualitative Case Study

Principles in Integrative Chiropractic

Principles in Integrative Chiropractic

Differences in Pain-related Characteristics Among Younger

Differences in Pain-related Characteristics Among Younger and Older Veterans Receiving Primary Care

Chiropractic or Osteopathic Manipulation for Children in the United States

Chiropractic or Osteopathic Manipulation for Children in the United States: An Analysis of Data from the 2007 National Health Interview Survey

The Effect of Chiropractic Treatment on Infantile Colic

The Effect of Chiropractic Treatment on Infantile Colic: Study Protocol for a Single-blind Randomized Controlled Trial

Chiropractic Integration into Private Sector Medical Facilities:
A Multisite Qualitative Case Study