Mccubbin Tracy, Kempe Karin L, Beck Arne
Founder and former Medical Director for the Centers for Complementary Medicine at Kaiser Permanente in Denver, CO.
Former Medical Director of Clinical Prevention Services in the Department of Population Care and Prevention Services at Kaiser Permanente in Denver, CO.
Perm J. 2017;21:16-172. doi: 10.7812/TPP/16-172.
Complementary and alternative medicine research has relied primarily on survey data from community populations rather than from patient populations receiving these services in integrated health care delivery systems (IHDS).
To describe patients seeking chiropractic, acupuncture, or massage therapy in a dedicated Center for Complementary Medicine (CCM) within an IHDS.
Patient surveys at the initial CCM visit included chief complaint, prior treatments, and relief with treatment (0% to 100% relief). A modified Brief Pain Inventory assessed average and current pain (0 = no pain; 10 = unbearable pain) and interference with life domains (1 = does not interfere; 10 = completely interferes). Demographics and CCM provider type were obtained from medical records. Analysis included patients who completed the survey.
Between 2007 and 2014, a total of 27,225 patients sought CCM services (median age = 50 years). Most (62%) were female, and 73% were white. Modalities included chiropractic (66.9%), acupuncture (18.1%), and massage (15.0%). Spine/truncal pain was most commonly reported (70.5%). A majority of patients (59%) saw their physician for their condition, 59% had not used CCM services previously, and 60% received medications for their condition. Mean ratings included pain relief with prior treatment (30.07%, standard deviation [SD] = 27.01%), current pain (4.33, SD = 2.4), and functional impairment ranging from 3.03 (SD = 3.09) for relationships to 5.42 (SD = 3.22) for enjoyment of life.
Spine/truncal pain was the most common complaint and chiropractic the most common modality among patients receiving CCM services in an IHDS. More than one-third of patients self-referred to the CCM.
补充和替代医学研究主要依赖于社区人群的调查数据,而非来自综合医疗服务提供系统(IHDS)中接受这些服务的患者群体的数据。
描述在IHDS内专门的补充医学中心(CCM)寻求脊椎按摩疗法、针灸或按摩治疗的患者情况。
患者在初次就诊CCM时进行的调查包括主诉、既往治疗情况以及治疗后的缓解情况(0%至100%缓解)。一份改良的简明疼痛问卷评估平均疼痛和当前疼痛(0 = 无疼痛;10 = 难以忍受的疼痛)以及对生活领域的干扰程度(1 = 无干扰;10 = 完全干扰)。人口统计学信息和CCM提供者类型从医疗记录中获取。分析纳入完成调查的患者。
2007年至2014年期间,共有27225名患者寻求CCM服务(中位年龄 = 50岁)。大多数(62%)为女性,73%为白人。治疗方式包括脊椎按摩疗法(66.9%)、针灸(18.1%)和按摩(15.0%)。最常报告的是脊柱/躯干疼痛(70.5%)。大多数患者(59%)因病情看过医生,59%以前未使用过CCM服务,60%因病情接受过药物治疗。平均评分包括既往治疗后的疼痛缓解情况(30.07%,标准差[SD] = 27.01%)、当前疼痛(4.33,SD = 2.4)以及功能障碍,从人际关系方面的3.03(SD = 3.09)到生活乐趣方面的5.42(SD = 3.22)不等。
在IHDS中接受CCM服务的患者中,脊柱/躯干疼痛是最常见的主诉,脊椎按摩疗法是最常见的治疗方式。超过三分之一的患者是自行前往CCM就诊的。