Integrating a Multidisciplinary Pain Team and Chiropractic Care in a Community Health Center
SOURCE: Journal of Primary Care & Community Health 2020 (Sep 10) ~ FULL TEXT
Christopher Prater 1, Melissa Tepe 2, Patrick Battaglia 3
1. Washington University School of Medicine, St. Louis, MO, USA.
2. Affinia Healthcare, St. Louis, MO, USA.
3. Logan University, Chesterfield, MO, USA.
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.
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