Nonpharmacologic Back Pain Treatment Use and Associated Patient Reported Outcomes in US-Based Integrative Medicine Clinics.
Background: The integrative medicine (IM) clinic is an innovative care model that may increase access to guideline-concordant nonpharmacologic treatment use in healthcare delivery systems for prevalent conditions such as low back pain (LBP). Objective: To describe the use and effectiveness of IM ser...
| Publicado en: | Global Advances in Integrative Medicine & Health pp. 1 - 14 |
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| Autores principales: | , , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Sage Publications Inc.
6/2/2025
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=185658021&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 185658021 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 27536130 N7A6 jtl: Global Advances in Integrative Medicine & Health issn: 27536130 maglogo: Y pubinfo: dt: 6/2/2025 pid: 344 pub: Sage Publications Inc. place: Thousand Oaks, California artinfo: ui: 185658021 185658021 185658021 10.1177/27536130251345481 185658021 ppf: 1 ppct: 13 formats: tig: atl: Nonpharmacologic Back Pain Treatment Use and Associated Patient Reported Outcomes in US-Based Integrative Medicine Clinics. aug: au: Roseen, Eric J. Hurstak, Emily E. Kim, Ryung S. Gao, Qi Greco, Carol M. Vago, David R. Saper, Robert B. Kligler, Benjamin McKee, M. Diane Dusek, Jeffery A. affil: Section of General Internal Medicine, Department of Medicine, 1836 Boston University Chobanian & Avedision School of Medicine and Boston Medical Center, Boston, MA, USA sug: subj: Low Back Pain Therapy Chronic Pain Therapy Patient-Reported Outcomes Functional Status Integrative Medicine Utilization Health Resource Utilization Health Facilities Funding Source United States Human Prospective Studies Models, Statistical Anxiety Depression Social Participation Acupuncture Chiropractic Physical Therapy Massage Descriptive Statistics Confidence Intervals Fatigue Sleep Disorders Implementation Science Questionnaires Scales Post Hoc Analysis Male Female Adult Middle Age Aged T-Tests Analysis of Variance Adult: 19-44 years Middle Aged: 45-64 years Aged: 65+ years Male Female ab: Background: The integrative medicine (IM) clinic is an innovative care model that may increase access to guideline-concordant nonpharmacologic treatment use in healthcare delivery systems for prevalent conditions such as low back pain (LBP). Objective: To describe the use and effectiveness of IM services for LBP in IM clinics. Research Design: Prospective cohort study. Subjects: Adult patients with LBP enrolled at seventeen IM clinics. Measures: Patterns of IM service use were assessed over 12 months. Changes in clinical outcomes were assessed between index visit and 12-month follow-up using linear mixed-effects models. Primary (pain interference, physical function) and secondary (pain intensity, anxiety, depression, fatigue, sleep disturbance, social participation) outcomes were obtained from the PROMIS-29 instrument. Results: We identified 660 participants with LBP (mean age = 51.6 years, 75% female). Over the 12-month study period, common IM services were IM consults (56%), acupuncture (44%), chiropractic care (24%), physical therapy (19%), and massage (17%). Over two-thirds (70%) of participants received at least one guideline-concordant nonpharmacologic treatment. Participants with follow-up outcome data (n = 443, 67%) reported a modest reduction in pain interference with life activities in the short- and long-term (2-month mean difference [MD] = −1.47, 95%CI = −2.98, −0.64; 12-month MD = −1.98, 95%CI = −3.12, −0.88). By contrast, improvements in physical function were not statistically or clinically significant (2-month MD = 0.37, 95%CI = −0.28, 1.01; 12-month MD = 0.69, 95%CI = −0.31, 1.69). At 12 months, small improvements were observed on all secondary outcomes (pain intensity, anxiety, depression, and social participation) except fatigue and sleep disturbance. Conclusions: Most patients with LBP receiving care at IM clinics received at least one guideline-recommended nonpharmacologic treatment. However, improvements on clinical outcomes were relatively small. Additional multi-site studies are needed to explore the optimal implementation approach. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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