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Randomized Controlled Trial
. 2012 Apr;18(4):354-62.
doi: 10.1089/acm.2011.0408. Epub 2012 Mar 28.

A model of integrative care for low-back pain

David M Eisenberg  1 , Julie E Buring, Andrea L Hrbek, Roger B Davis, Maureen T Connelly, Daniel C Cherkin, Donald B Levy, Mark Cunningham, Bonnie O'Connor, Diana E Post
Affiliations
Randomized Controlled Trial

A model of integrative care for low-back pain

David M Eisenberg et al. J Altern Complement Med. 2012 Apr.

Abstract

Objectives: While previous studies focused on the effectiveness of individual complementary and alternative medical (CAM) therapies, the value of providing patients access to an integrated program involving multiple CAM and conventional therapies remains unknown. The objective of this study is to explore the feasibility and effects of a model of multidisciplinary integrative care for subacute low-back pain (LBP) in an academic teaching hospital.

Design: This was a pilot randomized trial comparing an individualized program of integrative care (IC) plus usual care to usual care (UC) alone for adults with LBP.

Subjects: Twenty (20) individuals with LPB of 3-12 weeks' duration were recruited from an occupational health clinic and community health center.

Interventions: Participants were randomized to 12 weeks of individualized IC plus usual care versus UC alone. IC was provided by a trained multidisciplinary team offering CAM therapies and conventional medical care.

Outcome measures: The outcome measures were symptoms (pain, bothersomeness), functional status (Roland-Morris score), SF-12, worry, and difficulty performing three self-selected activities.

Results: Over 12 weeks, participants in the IC group had a median of 12.0 visits (range 5-25). IC participants experienced significantly greater improvements at 12 weeks than those receiving UC alone in symptom bothersomeness (p=0.02) and pain (p=0.005), and showed greater improvement in functional status (p=0.08). Rates of improvement were greater for patients in IC than UC in functional status (p=0.02), bothersomeness (p=0.002), and pain scores (p=0.001). Secondary outcomes of self-selected most challenging activity, worry, and the SF-12 also showed improvement in the IC group at 12 weeks. These differences persisted at 26 weeks, but were no longer statistically significant.

Conclusions: It was feasible for a multidisciplinary, outpatient IC team to deliver coordinated, individualized intervention to patients with subacute LBP. Results showed a promising trend for benefit of treating patients with persistent LBP with this IC model, and warrant evaluation in a full-scale study.

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Figures

FIG. 1.
FIG. 1.
Overview of study design. SF-12, Medical Outcomes Study Short-Form 12.
FIG. 2.
FIG. 2.
Integrative care team protocol for pilot randomized controlled trial. CAM, complementary and alternative medicine.
FIG. 3.
FIG. 3.
Recruitment and participation.
FIG. 4.
FIG. 4.
Study results: mean scores for Pain, Bothersomeness, and Roland (functional status). IC, integrative care; UC, usual care.
See this image and copyright information in PMC

References

    1. Eisenberg DM. Kessler RC. Foster C, et al. Unconventional medicine in the United States: Prevalence, costs, and patterns of use. NEJM. 1993;328:246–252. - PubMed
    1. Eisenberg DM. Davis RB. Ettner SL, et al. Trends in alternative medicine use in the United States, 1990–1997: Results of a follow-up national survey. JAMA. 1998;280:1569–1575. - PubMed
    1. Barnes PM. Powell-Griner E. McFann K. Nahin RL. Complementary and alternative medicine use among adults: United States, 2002. Adv Data. 2004;343:1–19. - PubMed
    1. Nahin RL. Barnes PM. Stussman BJ. Bloom B. Costs of complementary and alternative medicine (CAM) and frequency of visits to CAM practitioners: United States. Natl Health Stat Rep. 2009;18:1–15. - PubMed
    1. Maxion-Bergemeann S. Wolf M. Bornhoft G, et al. Complementary and alternative medicine costs: A systemic literature review. Forsch Komplementarmed. 2006;13(suppl 2):42–45. - PubMed

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