Integrative care for the management of low back pain: use of a clinical care pathway
Short Title: 
Integrative care for the management of low back pain

BACKGROUND: For the treatment of chronic back pain, it has been theorized that integrative care plans can lead to better outcomes than those achieved by monodisciplinary care alone, especially when using a collaborative, interdisciplinary, and non-hierarchical team approach. This paper describes the use of a care pathway designed to guide treatment by an integrative group of providers within a randomized controlled trial. METHODS: A clinical care pathway was used by a multidisciplinary group of providers, which included acupuncturists, chiropractors, cognitive behavioral therapists, exercise therapists, massage therapists and primary care physicians. Treatment recommendations were based on an evidence-informed practice model, and reached by group consensus. Research study participants were empowered to select one of the treatment recommendations proposed by the integrative group. Common principles and benchmarks were established to guide treatment management throughout the study. RESULTS: Thirteen providers representing 5 healthcare professions collaborated to provide integrative care to study participants. On average, 3 to 4 treatment plans, each consisting of 2 to 3 modalities, were recommended to study participants. Exercise, massage, and acupuncture were both most commonly recommended by the team and selected by study participants. Changes to care commonly incorporated cognitive behavioral therapy into treatment plans. CONCLUSION: This clinical care pathway was a useful tool for the consistent application of evidence-based care for low back pain in the context of an integrative setting. TRIAL REGISTRATION: NCT00567333.

Maiers, Michele J.
Westrom, Kristine K.
Legendre, Claire G.
Bronfort, Gert
Item Type: 
Journal Article
Publication Title: 
BMC health services research
Journal Abbreviation: 
BMC Health Serv Res
Publication Date: 
Publication Year: 
Library Catalog: 
PMID: 21034483 PMCID: PMC2984498

Turabian/Chicago Citation

Michele J. Maiers, Kristine K. Westrom, Claire G. Legendre and Gert Bronfort. 10/29/2010. "Integrative care for the management of low back pain: use of a clinical care pathway." BMC health services research 10: 298. 10.1186/1472-6963-10-298.

Wikipedia Citation

<ref> {{Cite journal | doi = 10.1186/1472-6963-10-298 | issn = 1472-6963 | volume = 10 | pages = 298 | last = Maiers | first = Michele J. | coauthors = Westrom, Kristine K., Legendre, Claire G., Bronfort, Gert | title = Integrative care for the management of low back pain: use of a clinical care pathway | journal = BMC health services research | date = 10/29/2010 | pmid = | pmc = }} </ref>