Improving Access to Chiropractic Care in Community Health Centers
- Conditions
- Lower Back Pain
- Interventions
- Other: Institutional interventionsOther: PCPs interventionsOther: Patient interventions
- Registration Number
- NCT06104605
- Lead Sponsor
- Boston Medical Center
- Brief Summary
The goal of this study is to evaluate the feasibility of new implementation strategies designed to increase the number of Primary Care Providers (PCPs) referrals to chiropractic care for lower back pain (LBP) in underserved populations. The investigators plan to pilot the strategies in three qualified community health centers (CHCs) and compare the number of LBP patients who receive referrals before and after implementation. The implementation strategies involve PCP, patient, and organizational interventions.
Patients presenting with LBP will be provided educational materials that focus on the safety and effectiveness of chiropractic care as an evidence-based treatment for LBP. Materials will be available in CHC common areas and may be sent to patients by their PCP via patient portal.
PCPs will participate in interactive lunch seminars to allow for inter-professional learning for PCPs. They will also participate in a survey regarding their attitudes and beliefs relating to chiropractic care. Currently, many PCPs cannot make chiropractic care referrals in the electronic health record (EHR). The investigators plan to add this option, or make it easier if the referral is already available.
This multi-level, multi-component approach will last two months, and will be rolled out sequentially in three clinics using a stepped-wedge design. The ordering of clinics will be random.
The primary outcome is the proportion of patients with LBP who received a referral to chiropractic care before and after the intervention. Secondary outcomes include referral to any non-pharmacologic treatment, use of imaging, and prescribed medications.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- ACTIVE_NOT_RECRUITING
- Sex
- All
- Target Recruitment
- 3
Not provided
Not provided
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Implementation PCPs interventions Implementation will be deployed at the CHC, PCP, and patient level. Implementation Institutional interventions Implementation will be deployed at the CHC, PCP, and patient level. Implementation Patient interventions Implementation will be deployed at the CHC, PCP, and patient level.
- Primary Outcome Measures
Name Time Method Change in PCP Chiropractor Referrals for LBP During the fourteen month study period This outcome will be assessed by calculating the proportion of LBP patients receiving a chiropractic referral for the two timeframe periods will be calculated. The numerator will be those with a chiropractic referral, defined as those LBP patients who received a PCP referral in the EHR or documentation in the EHR of a visit with a chiropractor. The denominator will be the total number of unique LBP patients seen by a PCP with an LBP diagnosis in the EHR.
- Secondary Outcome Measures
Name Time Method Percentage of patient participants referred to acupuncture 15 months Information for this outcome will be abstracted from the participants' medical records
Percentage of patient participants prescribed opioids 15 months Information for this outcome will be abstracted from the participants' medical records
Percentage of patient participants referred to magnetic resonance imaging (MRI) 15 months Information for this outcome will be abstracted from the participants' medical records
Percentage of patient participants referred to physical therapy 15 months Information for this outcome will be abstracted from the participants' medical records
Percentage of patient participants that receive epidural injections 15 months Information for this outcome will be abstracted from the participants' medical records
Trial Locations
- Locations (1)
Boston Medical Center
🇺🇸Boston, Massachusetts, United States