Perspectives of older adults on co-management of low back pain by doctors of chiropractic and family medicine physicians: a focus group study

doi:10.1186/1472-6882-13-225

PMC full text:

BMC Complement Altern Med. 2013; 13: 225.

Published online 2013 Sep 16. doi: 10.1186/1472-6882-13-225

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Table 4

Older adult perceptions of potential facilitators and barriers of low back pain co-management by MDs and DCs

	MD clinic		DC clinic		Senior center			Senior housing
LBP Co-management facilitators	M	M	D	D	C	C	C	H	H	H
	1	2	1	2	1	2	3	1	2	3
Co-management would benefit LBP patient	✓	✓	✓	✓	✓	✓	✓		✓	✓
Collegial approach needed for LBP care	✓	✓	✓	✓	✓	✓	✓	✓	✓	✓
Historically strained relations between MDs and DCs has improved over time	✓	✓	✓	✓		✓	✓	✓	✓	✓
Referrals/consultations/phone calls between MD and DC needed for co-management	✓	✓	✓	✓		✓	✓	✓	✓	✓
Coordinated LBP treatment plan	✓	✓	✓	✓	✓	✓	✓		✓	✓
Health record/X-ray sharing required	✓	✓		✓	✓	✓	✓	✓	✓	✓
Offices located together or nearby		✓	✓		✓		✓	✓
Individualized care for LBP	✓	✓				✓	✓	✓	✓
LBP Co-management barriers/concerns	M	M	D	D	C	C	C	H	H	H
	1	2	1	2	1	2	3	1	2	3
Medication: do not want to use any medicine, side effects, no improvement, narcotic addiction, masking pain	✓	✓	✓	✓	✓	✓	✓	✓	✓	✓
Financial costs or insurance issues from receiving care from 2 or more doctors	✓	✓	✓		✓	✓	✓	✓	✓	✓
Providers may not support a co-management approach to LBP care	✓	✓	✓		✓	✓	✓	✓	✓	✓
Chiropractic: Side effects, providers who do not treat a condition, no improvement	✓	✓	✓			✓	✓	✓	✓	✓
Receiving care from multiple doctors	✓				✓	✓	✓	✓	✓	✓
Duplicate/unneeded tests/treatments	✓				✓	✓	✓	✓	✓
Conflicting information or treatments	✓				✓	✓	✓	✓	✓
Scheduling and transportation concerns					✓	✓	✓	✓	✓	✓
Questionable benefit of either medical, chiropractic, or co-management based on previous LBP treatment experience					✓	✓	✓	✓	✓	✓

MD = Medical Doctor.

DC = Doctor of Chiropractic.

LBP = Low back pain.

M# = Medical clinic focus group 1 or 2.

D# = Chiropractic clinic focus group 1 or 2.

C# = Senior center focus group 1, 2 or 3.

H# = Senior housing focus group 1, 2 or 3.