Northwestern Health Sciences University, 2501 W 84th St Bloomington, MN 55431, USA.
BMC Health Serv Res. 2010 Oct 29;10:298. doi: 10.1186/1472-6963-10-298.
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.
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.
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.
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.
ClinicalTrials.gov NCT00567333.
对于慢性背痛的治疗，有人认为综合护理计划比单一学科护理更能带来更好的结果，尤其是在采用协作、跨学科和非层级团队方法时。本文介绍了在一项随机对照试验中，使用护理途径来指导综合治疗小组进行治疗的情况。
一个多学科的治疗小组，包括针灸师、脊椎指压治疗师、认知行为治疗师、运动治疗师、按摩治疗师和初级保健医生，使用了临床护理途径。治疗建议基于循证实践模型，并通过小组共识达成。研究参与者被授权从综合小组提出的治疗建议中选择一种。为了指导整个研究期间的治疗管理，制定了共同的原则和基准。
13 名代表 5 个医疗保健专业的提供者合作，为研究参与者提供综合护理。平均而言，向研究参与者推荐了 3 到 4 种治疗方案，每种方案由 2 到 3 种方式组成。团队最常推荐的是运动、按摩和针灸，也是研究参与者最常选择的。治疗计划的改变通常将认知行为疗法纳入其中。
在综合环境下，该临床护理途径是为慢性腰痛提供循证护理的有效工具。
ClinicalTrials.gov NCT00567333。
