Clinical trial NCT04923308: The Effect of Chiropractor-informed Triage on Low Back Pain Patient Outcomes and Trajectories
Official title: The Effect of Chiropractor-informed Triage Versus Usual Medical Management on Low Back Pain Patient Outcomes and Trajectories in Tertiary Care Settings: a Controlled Clinical Study.
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Low Back Pain
Triage
Keywords: Low back pain
triage
care pathways
chiropractor
pain
disability
health resources
Lead sponsor: Université du Québec à Trois-Rivières
Sponsor class: OTHER
First posted: 2021-06-11
Enrollment: 118
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: This study will involve individuals seeking medical consultation in the tertiary care public health system for an episode of LBP. The study will be conducted at the neurosurgery outpatient clinic affiliated to the Centre Intégré Universitaire de Santé et de Services Sociaux- Mauricie Centre du Québec (CIUSSS-MCQ; Trois-Rivières' regional healthcare organization). The CIUSSS-MCQ, established in 2015 as a result of the merger of 12 health and social services public institutions, totals 974 physicians, including 515 GPs. It serves a population of over 510,000 inhabitants, of which 83% are over 18 years of age (17).

Brief summary: Almost everyone will have low back pain (LBP) at some point in their lives. LBP is a complex multifactorial condition for which diagnosis and clinical management remains a challenge. Factors such as wait times, delays in diagnosis or proper referral can result in Canadian patients having difficulty getting the care that they need. The overall objective of this project is to explore how chiropractors, who specialize in the diagnosis and clinical management of spinal conditions, can transform healthcare trajectories and improve the health of patients with LBP by integrating medical specialist team.To do so, patients with low back pain seeking medical care within the public health system will be first seen by chiropractors. Chiropractors will play a key role in identifying the type of low back pain and subsequently offering guidance to medical specialists with regard to the best treatment and management options that are currently recommended. Participating patients will be followed over a year while extensive health-related data will be collected and compared to non-triage patients with LBP.


Eligibility criteria: Inclusion Criteria:

* Being ≥ 18 years of age
* Being scheduled in the outpatient clinics with a primary complaint of LBP (either acute, chronic or recurring episodes), consistent with LBP definition (pain between the lower rib margins and the buttock creases, with or without associated symptoms in the lower limb(s)).
* Being able to comprehend and express oneself in French

Exclusion Criteria:

* Patients involved in litigation related to their LBP condition (i.e., worker's compensation, public automobile insurance plan or other litigations)

Primary outcomes:
measure: Change from baseline in back and leg pain intensity (current and past week)
timeFrame: baseline, week 1, week 12, week 24 and 12 months follow-up
Secondary outcomes:
measure: Diagnosis made by the specialist
timeFrame: up to 4 weeks post-baseline assessment
measure: Number of requests for medical imaging
timeFrame: over a one year period
measure: Number of requests for laboratory tests
timeFrame: over a one year period
measure: Number of requests for medication prescriptions
timeFrame: over a one year period
measure: Number of subsequent visits to the outpatient clinic or medical specialist
timeFrame: over a one year period
measure: Number of visit to non-publicity funded care
timeFrame: over a one year period
measure: Disability
timeFrame: baseline, week 1, week 12, week 24 and 12 months follow-up
measure: Number of significant pain episodes of LBP
timeFrame: over a one year period
measure: Change from baseline Health-related quality of life
timeFrame: baseline, week 1, week 12, week 24 and 12 months follow-up
measure: General expectations of recovery
timeFrame: baseline
measure: Perceived Global Rating of Change
timeFrame: week 1, week 12, week 24 and 12 months follow-up
measure: Patient satisfaction
timeFrame: After the baseline assessment
Other outcomes:
Locations:
city: Trois-Rivieres
country: Canada
facility: Université du Québec à Trois-Rivières
state: Quebec
Study officials:
References: