Predictors of Visit Frequency for Patients Using Ongoing Chiropractic Care for Chronic Low Back and Chronic Neck Pain
Predictors of Visit Frequency for Patients Using Ongoing Chiropractic Care for Chronic Low Back and Chronic Neck Pain; Analysis of Observational Data
SOURCE: BMC Musculoskeletal Disorders 2020 (May 13); 21 (1): 298
Patricia M. Herman, PhD, Sarah E. Edgington, PhD, Eric L. Hurwitz, DC, PhD, & Ian D. Coulter, PhD
Santa Monica, CA, USA.
Background: Chronic spinal pain is prevalent, expensive and long-lasting. Several provider-based nonpharmacologic therapies have now been recommended for chronic low-back pain (CLBP) and chronic neck pain (CNP). However, healthcare and coverage policies provide little guidance or evidence regarding the long-term use of this care. To provide one glimpse into the long-term use of nonpharmacologic provider-based care, this study examines the predictors of visit frequency in a large sample of patients with CLBP and CNP using ongoing chiropractic care.
Methods: Observational data were collected from a large national sample of chiropractic patients in the US with non-specific CLBP and CNP. Visit frequency was defined as average number of chiropractic visits per month over the 3-month study period. Potential baseline predictor variables were entered into two sets of multi-level models according to a defined causal theory-in this case, Anderson’s Behavioral Model of Health Services Use.
Results: Our sample included 852 patients with CLBP and 705 with CNP. Visit frequency varied significantly by chiropractor/clinic, so our models controlled for this clustering. Patients with either condition used an average of 2.3 visits per month. In the final models visit frequency increased (0.44 visits per month, p = .008)
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