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Exploring Patient Satisfaction

By |September 24, 2014|Chiropractic Care, Patient Satisfaction|

Exploring Patient Satisfaction: A Secondary Analysis of a Randomized Clinical Trial of Spinal Manipulation, Home Exercise, and Medication for Acute and Subacute Neck Pain

The Chiro.Org Blog


SOURCE:   J Manipulative Physiol Ther 2014 (Sep 5)


Brent D. Leininger, DC, Roni Evans, DC, PhD,
Gert Bronfort, DC, PhD

Research Fellow, Integrative Health & Wellbeing Research Program,
Center for Spirituality & Healing, University of Minnesota,
Minneapolis, MN.
lein0122@umn.edu


OBJECTIVE:   The purpose of this study was to assess satisfaction with specific aspects of care for acute neck pain and explore the relationship between satisfaction with care, neck pain, and global satisfaction.

METHODS:   This study was a secondary analysis of patient satisfaction from a randomized trial of spinal manipulation therapy (SMT) delivered by doctors of chiropractic, home exercise and advice (HEA) delivered by exercise therapists, and medication (MED) prescribed by a medical doctors for acute/subacute neck pain. Differences in satisfaction with specific aspects of care were analyzed using a linear mixed model. The relationship between specific aspects of care and (1) change in neck pain (primary outcome of the randomized trial) and (2) global satisfaction were assessed using Pearson’s correlation and multiple linear regression.

RESULTS:   Individuals receiving SMT or HEA were more satisfied with the information and general care received than MED group participants. Spinal manipulation therapy and HEA groups reported similar satisfaction with information provided during treatment; however, the SMT group was more satisfied with general care. Satisfaction with general care (r = -0.75 to -0.77; R2 = 0.55-0.56) had a stronger relationship with global satisfaction compared with satisfaction with information provided (r = -0.65 to 0.67; R2 = 0.39-0.46). The relationship between satisfaction with care and neck pain was weak (r = 0.17-0.38; R2 = 0.08-0.21).

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Patient Satisfaction With Chiropractic Page

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There Will Never Be Enough Research To Satisfy Our Critics

By |January 24, 2013|Chiropractic Care, Evidence-based Medicine, Health Care Reform, Patient Satisfaction, Spinal Manipulation|

There Will Never Be Enough Research To Satisfy Our Critics

The Chiro.Org Blog


A Chiro.Org Editorial


For some, there will never be enough research to support the use of chiropractic. These people will forever hide behind the claim that they wish to protect patients from quackish practices.

For those who may have forgotten, or for those who never knew, organized medicine spent decades and tens of millions of dollars trying to discredit and destroy chiropractic. Today, the vestiges of that oppression is still found on fringe web sites that ignore the body of peer-reviewed research supporting chiropractic care.

The Wilk anti-trust case against the AMA and 20 other named medical groups revealed that the AMA Plan was to:

  • Undermine Chiropractic schools

  • Undercut insurance programs for Chiropractic patients

  • Conceal evidence of the effectiveness of Chiropractic care

  • Subvert government inquires into the effectiveness of Chiropractic, and

  • Promote other activities that would control the monopoly that the AMA had on health care

  • They even threatened their own ranks: any MD who taught in our schools, performed research with chiropractors, or accepted a referral from, or made a referral to a chiropractor, would lose their hospital privileges, leaving them unable to treat patients.

while, all along, they knew that:<

There also was some evidence before the Committee that chiropractic was effective – more effective than the medical profession in treating certain kinds of problems such as workmen’s back injuries.

The Committee on Quackery was also aware that some medical physicians believed chiropractic to be effective and that chiropractors were better trained to deal with musculoskeletal problems than most medical physicians.

(Opinion pp. 7)

(more…)

Symptomatic Reactions, Clinical Outcomes and Patient Satisfaction

By |August 16, 2012|Patient Satisfaction, Safety, Upper Cervical Adjusting|

Symptomatic Reactions, Clinical Outcomes and Patient Satisfaction Associated with Upper Cervical Chiropractic Care: A Prospective, Multicenter, Cohort Study

The Chiro.Org Blog


SOURCE:   BMC Musculoskelet Disord. 2011 (Oct 5); 12: 219


Kirk Eriksen, Roderic P Rochester, and Eric L Hurwitz

Chiropractic Health Institute, PC, Clinic Director, 2500 Flowers Chapel Road, Dothan, AL 36305, USA. drkirke@graceba.net


BACKGROUND:   Observational studies have previously shown that adverse events following manipulation to the neck and/or back are relatively common, although these reactions tend to be mild in intensity and self-limiting. However, no prospective study has examined the incidence of adverse reactions following spinal adjustments using upper cervical techniques, and the impact of this care on clinical outcomes.

METHODS:   Consecutive new patients from the offices of 83 chiropractors were recruited for this practice-based study. Clinical outcome measures included:

  1. Neck pain disability index (100-point scale),
  2. Oswestry back pain index (100-point scale),
  3. 11-point numerical rating scale (NRS) for neck, headache, midback, and low back pain,
  4. treatment satisfaction, and
  5. Symptomatic Reactions (SR).

Data were collected at baseline, and after approximately 2 weeks of care. A patient reaching sub-clinical status for pain and disability was defined as a follow-up score <3 NRS and <10%, respectively. A SR is defined as a new complaint not present at baseline or a worsening of the presenting complaint by >30% based on an 11-point numeric rating scale occurring <24 hours after any upper cervical procedure.

RESULTS:   A total of 1,090 patients completed the study having 4,920 (4.5 per patient) office visits requiring 2,653 (2.4 per patient) upper cervical adjustments over 17 days. Three hundred thirty- eight (31.0%) patients had SRs meeting the accepted definition. Intense SR (NRS ≥8) occurred in 56 patients (5.1%). Outcome assessments were significantly improved for neck pain and disability, headache, mid-back pain, as well as lower back pain and disability (p <0.001) following care with a high level (mean = 9.1/10) of patient satisfaction. The 83 chiropractors administered >5 million career upper cervical adjustments without a reported incidence of serious adverse event.

CONCLUSIONS:   Upper cervical chiropractic care may have a fairly common occurrence of mild intensity SRs short in duration (<24 hours), and rarely severe in intensity; however, outcome assessments were significantly improved with less than 3 weeks of care with a high level of patient satisfaction. Although our findings need to be confirmed in subsequent randomized studies for definitive risk-benefit assessment, the preliminary data shows that the benefits of upper cervical chiropractic care may outweigh the potential risks.


 

From the FULL TEXT Article:

Discussion: (more…)

Cervical Radiculopathy: A Systematic Review on Treatment by Spinal Manipulation and Measurement with the Neck Disability Index

By |June 4, 2012|Chiropractic Care, Patient Satisfaction, Radiculopathy|

Cervical Radiculopathy: A Systematic Review on Treatment by Spinal Manipulation and Measurement with the Neck Disability Index

The Chiro.Org Blog


SOURCE:   J Can Chiro Assoc. 2012 (Mar); 56 (1): 18–28 ~ FULL TEXT


Robert J. Rodine, BSc, DC, Howard Vernon, DC, PhD, FCCS(C)

Graduate Education and Research Programs,
Canadian Memorial Chiropractic College,
Toronto, Ontario.


Cervical radiculopathy (CR), while less common than conditions with neck pain alone, can be a significant cause of neck pain and disability; thus the determination of adequate treatment options for patients is essential. Currently, inadequate scientific literature restricts specific conservative management recommendations for CR. Despite a paucity of evidence for high-velocity low-amplitude (HVLA) spinal manipulation in the treatment for CR, this strategy has been frequently labeled as contraindicated. Scientific support for appropriate outcome measures for CR is equally deficient. While more scientific data is needed to draw firm conclusions, the present review suggests that spinal manipulation may be cautiously considered as a therapeutic option for patients suffering from CR. With respect to outcome measures, the Neck Disability Index appears well-suited for spinal manipulative treatment of CR.

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Radiculopathy and Chiropractic Page

 

From the FULL TEXT Article

Introduction

Cervical radiculopathy (CR) can be a significant cause of neck pain and disability. The reported annual incidence of CR is 83.2/100,000 persons [1], while the reported prevalence is 3.5/1000 persons. [2] Gender preference varies. [2, 3] Individuals are most commonly affected in the 5th and 6th decades of life. [1, 4] Physical exertion or trauma at onset is rare, involving less than 15%. [1] Causal relationship to an automobile accident ranges from 3–23%. [1, 4] (more…)

Chiropractic Research & Practice: State of the Art

By |February 24, 2012|Cost-Effectiveness, Evidence-based Medicine, Health Care Reform, Outcome Assessment, Patient Satisfaction, Prevention, Public Health, Research, Spinal Manipulation, Wellness Care|

Chiropractic Research & Practice State of the Art

The Chiro.Org Blog


SOURCE:   Cleveland Chiropractic College


By Daniel Redwood, D.C., professor,
Cleveland Chiropractic College

Peer Reviewers: Carl S. Cleveland III, D.C., J.
Michael Flynn, D.C., Cheryl Hawk, D.C., PhD., and
Anthony Rosner, PhD.

©2010 Cleveland Chiropractic College –
Kansas City and Los Angeles


Chiropractic Research & Practice

State of the Art

Since chiropractic’s breakthrough decade in the 1970s — when the U.S. federal government included chiropractic services in Medicare and federal workers’ compensation coverage, approved the Council on Chiropractic Education (CCE) as the accrediting body for chiropractic colleges, and sponsored a National Institutes of Health (NIH) conference on the research status of spinal manipulation — the profession has grown and matured into an essential part of the nation’s healthcare system.

Chiropractic was born in the United States in the late 19th century and the U.S. is home to approximately 65,000 of the world’s 90,000 chiropractors. [1] The chiropractic profession is the third largest independent health profession in the Western world, after medicine and dentistry. Doctors of chiropractic are licensed throughout the English-speaking world and in many other nations as primary contact providers, licensed for both diagnosis and treatment without medical referral. In 2005, the World Health Organization (WHO) published WHO Guidelines on Basic Training and Safety in Chiropractic, which documented the status of chiropractic education and practice worldwide and sought to ensure high standards in nations where chiropractic is in the early stages of development. [2]

Rigorous educational standards are supervised by government-recognized accrediting agencies in many nations, including CCE in the United States. After fulfilling college science prerequisites similar to those required to enter medical schools, chiropractic students must complete a chiropractic college program of four academic years, which includes a wide range of courses in anatomy, physiology, pathology, and diagnosis, as well as spinal adjusting, physiotherapy, rehabilitation, public health and nutrition. (more…)

Short Story: My first experience at a chiropractic session

By |June 7, 2010|Patient Satisfaction|

Source JoyOnline

Manasseh Azure Awuni, a Level 400 student of the Ghana Institute of Journalism, writes about her first chiropractic experience in Ghana.

It is one of the names you hear and if you have not consulted your dictionary, you do not have the faintest idea what it looks like. I had heard the word Chiropractic and Wellness Centres not long ago and my imagination about it was not different from how I perceived the word “internet” when I was leaving Kete-Krachi for Accra four years ago.

As I walked into the Asylum Down (Prestige Centre) of the Chiropractic and Wellness Centres, that Monday evening, not only did I not know the meaning of chiropractic but I also did not know the right pronunciation of the first syllable of the word. I didn’t know that the first syllable of the word, which starts like children is pronounced like the capital of Egypt. The conclusion I drew was that Chiropractic and Wellness Centres were unknown because I thought I was current enough to know the current happenings in town. I was however proven wrong when I entered after receiving a VIP treatment at the entrance. In Ghana, I can count from the fingers of my right hand the number of organisations the door is opened for you to enter. (more…)