ARTICLE
Adding chiropractic care to usual medical care was associated with improved outcomes at a reasonable cost in a sample of complex patients with sub-acute and chronic back pain. The efficacy for chiropractic care including manipulative therapy in treating patients with spine-related pain has been established. Moreover, clinical trials have shown greater efficacy when chiropractic treatment is added to usual medical care in managing patients with these conditions. Chiropractic care also has the potential to be cost-effective, as chiropractors typically use a conservative (i.e. non-pharmacological, non-surgical) approach. In fact, studies have shown that when managed by a chiropractor, even when controlling for confounding factors, patients tend to have fewer advanced medical procedures including opioids and referrals for diagnostic imaging, injections, or spinal surgery. Although chiropractic care has been suggested as a cost-effective alternative to the medical management of spine-related pain disorders, the evidence for economic evaluations of chiropractic treatment compared with, or added to, medical care is inconclusive. To evaluate costs and consequences of a new back pain service provided by chiropractors integrated into a Community Health Centre in Cambridge, Ontario. The study sample included 95 consecutive patients presenting between January 2014 to January 2016 with a mixture of sub-acute and chronic back pain. CHCs are non-profit, publicly funded and community-governed organizations that promote health, illness prevention, and community development. These centers employ multidisciplinary teams of health professionals that traditionally include medical doctors, nurse practitioners, registered nurses, dietitians, social workers, and community health workers. Musculoskeletal disorders including chronic back pain are also prevalent among the groups served by these centers. To improve the management of these patients, particularly in the clinical area of low back pain, a growing number of Ontario CHCs have been adding chiropractic care to their existing medical services. According to the EuroQol 5 Domain questionnaire in this study, nearly 70% of patients improved. The mean number of treatment sessions was 8.4, and an average of 0.21 QALYs were gained at an average cost per QALY of $1,042. Seventy-seven percent of patients did not visit their primary care provider over the 90-day period, representing potential cost savings to the institution of between $2,022.23 and $6,135.82. Source: https://chiro.org/wordpress/2019/10/chiropractic-integration-within-a-community-health-centre/