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Clinical outcomes in a large cohort of musculoskeletal patients undergoing chiropractic care in the United Kingdom: a comparison of self and NHS referral routes

Clinical outcomes in a large cohort of musculoskeletal patients undergoing chiropractic care in the United Kingdom: a comparison of self and NHS referral routes
Clinical outcomes in a large cohort of musculoskeletal patients undergoing chiropractic care in the United Kingdom: a comparison of self and NHS referral routes
OBJECTIVE:
An innovative commissioning pathway has recently been introduced in the United Kingdom allowing chiropractic organizations to provide state-funded chiropractic care to patients through referral from National Health Service (NHS) primary care physicians. The purpose of this study was to examine the outcomes of NHS and private patient groups presenting with musculoskeletal conditions to chiropractors under the Any Qualified Provider scheme and compare the clinical outcomes of these patients with those presenting privately.
METHODS:
A prospective cohort design monitoring patient outcomes comparing self-referring and NHS-referred patients undergoing chiropractic care was used. The primary outcome was the change in Bournemouth Questionnaire scores. Within- and between-group analyses were performed to explore differences between outcomes with additional analysis of subgroups as categorized by the STarT back tool.
RESULTS:
A total of 8222 patients filled in baseline questionnaires. Of these, NHS patients (41%) had more adverse health measures at baseline and went on to receive more treatment. Using percent change in Bournemouth Questionnaire scores categorized at minimal clinical change cutoffs and adjusting for baseline differences, patients with low back and neck pain presenting privately are more likely to report improvement within 2 weeks and to have slightly better outcomes at 90 days. However, these patients were more likely to be attending consultations beyond 30 days.
CONCLUSIONS:
This study supports the contention that chiropractic services as provided in United Kingdom are appropriate for both private and NHS-referred patient groups and should be considered when general medical physicians make decisions concerning referral routes and pain pathways for patients with musculoskeletal conditions.
0161-4754
54-62
Field, Jonathan
61b0ca4a-3907-4847-b0b5-506e1929fc51
Newell, David
f1a21938-9604-4f10-aac2-bb19337a638e
Field, Jonathan
61b0ca4a-3907-4847-b0b5-506e1929fc51
Newell, David
f1a21938-9604-4f10-aac2-bb19337a638e

Field, Jonathan and Newell, David (2016) Clinical outcomes in a large cohort of musculoskeletal patients undergoing chiropractic care in the United Kingdom: a comparison of self and NHS referral routes. Journal of Manipulative and Physiological Therapeutics, 39 (1), 54-62. (doi:10.1016/j.jmpt.2015.12.003).

Record type: Article

Abstract

OBJECTIVE:
An innovative commissioning pathway has recently been introduced in the United Kingdom allowing chiropractic organizations to provide state-funded chiropractic care to patients through referral from National Health Service (NHS) primary care physicians. The purpose of this study was to examine the outcomes of NHS and private patient groups presenting with musculoskeletal conditions to chiropractors under the Any Qualified Provider scheme and compare the clinical outcomes of these patients with those presenting privately.
METHODS:
A prospective cohort design monitoring patient outcomes comparing self-referring and NHS-referred patients undergoing chiropractic care was used. The primary outcome was the change in Bournemouth Questionnaire scores. Within- and between-group analyses were performed to explore differences between outcomes with additional analysis of subgroups as categorized by the STarT back tool.
RESULTS:
A total of 8222 patients filled in baseline questionnaires. Of these, NHS patients (41%) had more adverse health measures at baseline and went on to receive more treatment. Using percent change in Bournemouth Questionnaire scores categorized at minimal clinical change cutoffs and adjusting for baseline differences, patients with low back and neck pain presenting privately are more likely to report improvement within 2 weeks and to have slightly better outcomes at 90 days. However, these patients were more likely to be attending consultations beyond 30 days.
CONCLUSIONS:
This study supports the contention that chiropractic services as provided in United Kingdom are appropriate for both private and NHS-referred patient groups and should be considered when general medical physicians make decisions concerning referral routes and pain pathways for patients with musculoskeletal conditions.

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More information

e-pub ahead of print date: 1 February 2016

Identifiers

Local EPrints ID: 416494
URI: https://eprints.soton.ac.uk/id/eprint/416494
ISSN: 0161-4754
PURE UUID: 08ffa9b3-c2e2-41dd-8bb6-d77f3e75a0cd
ORCID for David Newell: ORCID iD orcid.org/0000-0003-1462-3586

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Date deposited: 20 Dec 2017 17:30
Last modified: 19 Nov 2019 01:25

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