Acupuncture and chiropractic care for chronic pain in an integrated health plan: a mixed methods study

Persistent Link:
http://hdl.handle.net/10150/610357
Title:
Acupuncture and chiropractic care for chronic pain in an integrated health plan: a mixed methods study
Author:
DeBar, Lynn; Elder, Charles; Ritenbaugh, Cheryl; Aickin, Mikel; Deyo, Rick; Meenan, Richard; Dickerson, John; Webster, Jennifer; Jo Yarborough, Bobbi
Affiliation:
Kaiser Permanente, The Center for Health Research, Portland, Oregon, USA; Department of Family & Community Medicine, University of Arizona, Tucson, Arizona, USA; Department of Family Medicine, Oregon Health and Science University, Portland, Oregon, USA
Issue Date:
2011
Publisher:
BioMed Central
Citation:
DeBar et al. BMC Complementary and Alternative Medicine 2011, 11:118 http://www.biomedcentral.com/1472-6882/11/118
Journal:
BMC Complementary and Alternative Medicine
Rights:
© 2011 DeBar et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0)
Collection Information:
This item is part of the UA Faculty Publications collection. For more information this item or other items in the UA Campus Repository, contact the University of Arizona Libraries at repository@u.library.arizona.edu.
Abstract:
BACKGROUND:Substantial recent research examines the efficacy of many types of complementary and alternative (CAM) therapies. However, outcomes associated with the "real-world" use of CAM has been largely overlooked, despite calls for CAM therapies to be studied in the manner in which they are practiced. Americans seek CAM treatments far more often for chronic musculoskeletal pain (CMP) than for any other condition. Among CAM treatments for CMP, acupuncture and chiropractic (A/C) care are among those with the highest acceptance by physician groups and the best evidence to support their use. Further, recent alarming increases in delivery of opioid treatment and surgical interventions for chronic pain--despite their high costs, potential adverse effects, and modest efficacy--suggests the need to evaluate real world outcomes associated with promising non-pharmacological/non-surgical CAM treatments for CMP, which are often well accepted by patients and increasingly used in the community.METHODS/DESIGN:This multi-phase, mixed methods study will: (1) conduct a retrospective study using information from electronic medical records (EMRs) of a large HMO to identify unique clusters of patients with CMP (e.g., those with differing demographics, histories of pain condition, use of allopathic and CAM health services, and comorbidity profiles) that may be associated with different propensities for A/C utilization and/or differential outcomes associated with such care; (2) use qualitative interviews to explore allopathic providers' recommendations for A/C and patients' decisions to pursue and retain CAM care; and (3) prospectively evaluate health services/costs and broader clinical and functional outcomes associated with the receipt of A/C relative to carefully matched comparison participants receiving traditional CMP services. Sensitivity analyses will compare methods relying solely on EMR-derived data versus analyses supplementing EMR data with conventionally collected patient and clinician data.DISCUSSION:Successful completion of these aggregate aims will provide an evaluation of outcomes associated with the real-world use of A/C services. The trio of retrospective, qualitative, and prospective study will also provide a clearer understanding of the decision-making processes behind the use of A/C for CMP and a transportable methodology that can be applied to other health care settings, CAM treatments, and clinical populations.TRIAL REGISTRATION:ClinicalTrials.gov: NCT01345409
EISSN:
1472-6882
DOI:
10.1186/1472-6882-11-118
Version:
Final published version
Additional Links:
http://www.biomedcentral.com/1472-6882/11/118

Full metadata record

DC FieldValue Language
dc.contributor.authorDeBar, Lynnen
dc.contributor.authorElder, Charlesen
dc.contributor.authorRitenbaugh, Cherylen
dc.contributor.authorAickin, Mikelen
dc.contributor.authorDeyo, Ricken
dc.contributor.authorMeenan, Richarden
dc.contributor.authorDickerson, Johnen
dc.contributor.authorWebster, Jenniferen
dc.contributor.authorJo Yarborough, Bobbien
dc.date.accessioned2016-05-20T09:05:02Z-
dc.date.available2016-05-20T09:05:02Z-
dc.date.issued2011en
dc.identifier.citationDeBar et al. BMC Complementary and Alternative Medicine 2011, 11:118 http://www.biomedcentral.com/1472-6882/11/118en
dc.identifier.doi10.1186/1472-6882-11-118en
dc.identifier.urihttp://hdl.handle.net/10150/610357-
dc.description.abstractBACKGROUND:Substantial recent research examines the efficacy of many types of complementary and alternative (CAM) therapies. However, outcomes associated with the "real-world" use of CAM has been largely overlooked, despite calls for CAM therapies to be studied in the manner in which they are practiced. Americans seek CAM treatments far more often for chronic musculoskeletal pain (CMP) than for any other condition. Among CAM treatments for CMP, acupuncture and chiropractic (A/C) care are among those with the highest acceptance by physician groups and the best evidence to support their use. Further, recent alarming increases in delivery of opioid treatment and surgical interventions for chronic pain--despite their high costs, potential adverse effects, and modest efficacy--suggests the need to evaluate real world outcomes associated with promising non-pharmacological/non-surgical CAM treatments for CMP, which are often well accepted by patients and increasingly used in the community.METHODS/DESIGN:This multi-phase, mixed methods study will: (1) conduct a retrospective study using information from electronic medical records (EMRs) of a large HMO to identify unique clusters of patients with CMP (e.g., those with differing demographics, histories of pain condition, use of allopathic and CAM health services, and comorbidity profiles) that may be associated with different propensities for A/C utilization and/or differential outcomes associated with such careen
dc.description.abstract(2) use qualitative interviews to explore allopathic providers' recommendations for A/C and patients' decisions to pursue and retain CAM careen
dc.description.abstractand (3) prospectively evaluate health services/costs and broader clinical and functional outcomes associated with the receipt of A/C relative to carefully matched comparison participants receiving traditional CMP services. Sensitivity analyses will compare methods relying solely on EMR-derived data versus analyses supplementing EMR data with conventionally collected patient and clinician data.DISCUSSION:Successful completion of these aggregate aims will provide an evaluation of outcomes associated with the real-world use of A/C services. The trio of retrospective, qualitative, and prospective study will also provide a clearer understanding of the decision-making processes behind the use of A/C for CMP and a transportable methodology that can be applied to other health care settings, CAM treatments, and clinical populations.TRIAL REGISTRATION:ClinicalTrials.gov: NCT01345409en
dc.language.isoenen
dc.publisherBioMed Centralen
dc.relation.urlhttp://www.biomedcentral.com/1472-6882/11/118en
dc.rights© 2011 DeBar et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0)en
dc.titleAcupuncture and chiropractic care for chronic pain in an integrated health plan: a mixed methods studyen
dc.typeArticleen
dc.identifier.eissn1472-6882en
dc.contributor.departmentKaiser Permanente, The Center for Health Research, Portland, Oregon, USAen
dc.contributor.departmentDepartment of Family & Community Medicine, University of Arizona, Tucson, Arizona, USAen
dc.contributor.departmentDepartment of Family Medicine, Oregon Health and Science University, Portland, Oregon, USAen
dc.identifier.journalBMC Complementary and Alternative Medicineen
dc.description.collectioninformationThis item is part of the UA Faculty Publications collection. For more information this item or other items in the UA Campus Repository, contact the University of Arizona Libraries at repository@u.library.arizona.edu.en
dc.eprint.versionFinal published versionen
All Items in UA Campus Repository are protected by copyright, with all rights reserved, unless otherwise indicated.