Ontarians and Family Physicians in Favour of More Team-Based Care to Help Manage Back Pain, New Study Shows

Recent Pilot project shows quicker access to treatment and faster diagnoses for low back pain patients when using chiropractors in teams with family physicians

TORONTO, June 12, 2012 /CNW/ - Low back pain is a major health issue in Ontario.  It affects 84 per cent of the working population at some point in their life and is second only to the common cold as a cause of lost work time.  According to new research Ontarians and physicians are open to new ways to deal with back pain. Less than one in five Ontarians say their back pain is resolved quickly and easily, with a majority being in favour of including chiropractors in teams with family physicians for the management of their back pain - and family physicians agree.

New research from the Ontario Chiropractic Association (OCA) conducted by Environics Research Group shows the vast majority (93 per cent) of family physicians frequently treat patients with low back pain and more than half (55 per cent) find it challenging to treat these patients on their own.  Three-quarters (75 per cent) say they think their patients suffering from low back pain could benefit from treatment options offered by other healthcare professionals.

"Chronic low back pain patients are commonly referred to orthopedic surgeons, even though about 90 per cent are not surgical candidates.  They are also often referred for unnecessary expensive diagnostic services such as MRIs," says Dr. Robert Haig, Chief Executive Officer of the Ontario Chiropractic Association. "We believe that by collaborating with family physicians to deliver evidence-informed low back pain care, we can provide patient-centred, positive results for Ontarians.  This is why we pilot tested the Ministry of Health long Term Care funded 'Consulting Chiropractor' model of care."

The OCA pilot project evaluated the benefits of involving chiropractors in a primary care team-based setting, by assessing patients with low back pain, and discussing treatment options with the patient's family physician.

Results of the pilot project showed that a 30-minute assessment from a chiropractor resulted in a reduction in requests for MRIs and referrals to surgical specialists as reported by the participating family physicians.  From the perspective of the participating family physicians a quick turnaround between them and the chiropractor resulted in increased patient confidence in diagnosis and treatment options.

Currently, Ontarians are seeking treatment from a variety of healthcare providers for their back pain, such as chiropractors, physiotherapists, specialist physicians and registered massage therapists.  Three quarters (74 per cent) think it would be a better use of our healthcare dollars if professionals such as chiropractors were used more in teams with family physicians.

"Across the province, family doctors are starting to work in innovative and collaborative ways with other healthcare professionals. There is so much more that we can do when we work in teams", says Jan Kasperski, Chief Executive Officer of the Ontario College of Family Physicians. "Back pain is a common problem that causes significant disability. Better management of these patients by family doctors supported by the expertise of various healthcare professionals such as chiropractors and physiotherapists is a solution that will ensure Ontarians with back pain will receive the best care possible."

Collaboration is already happening in a number of ways across the province, with over 74% of family physicians referring to chiropractorsⁱ , and that number is increasing.

"The Drummond Report and the Ministry's own Action Plan make it clear that patient-centred, collaborative care is the way of the future," says Dr. Robert Haig.  "We are encouraged by this language, and the results of our recent studies demonstrate that this is what Ontarians, and family physicians, want too."

Back Pain is a major health issue for Ontario

• Low back is a major cause of healthcare expenditure with direct and indirect costs amounting to $1.2 billion a year in Ontario alone.ⁱⁱ
• At any given point in time, 15 per cent of the population suffers from chronic low back pain. ⁱⁱⁱ
• Low back problems are second only to cardiovascular disease as a major cause of chronic health problems & long term disability^iv

About the Studies: Methodology
The Ontario Chiropractic Association conducted two separate studies, one with Ontario residents and one with Ontario family physicians to gauge their attitudes towards using other healthcare providers, including chiropractors, as part of a multidisciplinary team to manage low back pain. The physician study was completed online from April 26, 2012 to May 7, 2012 using Environics Research Group's online physician panel. A total of 100 general practitioners / family physician from Ontario participated in the survey.  A probability sample of the same size would yield a margin of error of ±9.76 per cent, 19 times out of 20.  The Ontario resident survey was completed online from April 25, 2012 to May 7, 2012 using Environics Research Group's online panel. A total of 1,231 Ontario residents participated in the study.  A probability sample of the same size would yield a margin of error of ±2.79 per cent, 19 times out of 20.

About The Ontario Chiropractic Association
Founded in 1929, the Ontario Chiropractic Association represents the professional interests of more than 3,200 Ontario chiropractors. Chiropractic is a non-invasive, hands-on health care discipline that focuses on treatment and preventative care for disorders related to the spine, pelvis, nervous system and joints. Chiropractors are primary care practitioners, trained to develop and carry out a comprehensive treatment/management plan, recommend therapeutic exercise and other non-invasive therapies, and provide nutritional, dietary and lifestyle counseling. More than two million Ontarians rely on chiropractic care every year to help them get back to work and back to doing the things they love. For more information about chiropractic care or to find a chiropractor in your area, go to www.chiropractic.on.ca.

Notes To Editors
According to Health Force Ontario, 'Team Based Care' is the provision of comprehensive health services to patients by multiple health caregivers who work collaboratively to deliver quality care within and across settings.

ⁱ Busse JW, Canga A, Riva JJ, Viggiani D, Dilauro M, Kapend PI, Harvey M-P, Pagé I, Moore A, Gauthier CA, Price DJ. Attitudes towards Chiropractic: A Survey of Canadian Family Physicians. Accepted for an oral presentation at the 2011 Family Medicine Forum. Montreal, Canada. November 3-5, 2011.

ⁱⁱ Ontario Chiropractic Association, 2004.  Manga P, Angus D, et al. (1993).  The effectiveness and cost-effectiveness of chiropractic management of low-back pain.  Statistics Canada.  Health status of Canadians:  Report of the 1991 General Social Survey, Ottawa, 1994.

ⁱⁱⁱ Laxmaiah Manchikanti, MD1, Vijay Singh, MD2, Sukdeb Datta, MD3, Steven P. Cohen, MD4, and Joshua A. Hirsch, MD5, Comprehensive Review of Epidemiology, Scope,and Impact of Spinal Pain, 2009.

^iv Stokes J, Desjardins S, et al.  Economic Burden in Health Canada.  Arthritis in Canada: An ongoing challenge.  Ottawa:  Health Canada, 2003 (Cat. # H39-4/14-2003E), pp. 42.

Sheba Zaidi
Environics Communications
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Miguel Pacheco
Ontario Chiropractic Association
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