Many Chronic Pain Patients Fail to Mention Alternative Therapies

New research discovers more than half of chronic pain patients in a managed care setting reported using chiropractic care or acupuncture or both, but often did not discuss this care with their primary care providers.

The findings suggest that improved communication is needed among patients and physicians to improve care coordination.

The study results appear in the American Journal of Managed Care.

Researchers surveyed more than 6,000 patients in Oregon and Washington who were Kaiser Permanente members from 2009 – 2011 and had three or more outpatient visits for chronic pain within 18 months. They found that 58 percent of these patients had used chiropractic care or acupuncture or both.

The majority of patients shared information about these alternative therapies with their primary care provider, however a good portion (35 percent of patients who had acupuncture only, and 42 percent of patients who had chiropractic care only) didn’t talk to their providers about this care.

Interestingly, most all of these patients said they would be happy to share this information if their provider asked.

“Our study confirms that most of our patients with chronic pain are seeking complementary treatments to supplement the care we provide in the primary care setting,” said Charles Elder, M.D., M.P.H., lead author of the study.

“The problem is that too often, doctors don’t ask about this treatment, and patients don’t volunteer the information.”

Chronic pain affects approximately 100 million Americans each year and costs nearly $600 billion, according to report from the Institute of Medicine.

Elder, who is also the physician lead for Kaiser Permanente’s complementary and alternative medicine program, added, “We want our patients to get better, so we need to ask them about the alternative and complementary approaches they are using. If we know what’s working and what’s not working, we can do a better job advising patients, and we may be able to recommend an approach they haven’t tried.”

Investigators accessed the use of alternative care by examining the medical records of patients who received acupuncture or chiropractic care in 2011. A majority of patients (66 percent) who received acupuncture obtained the services through their health plan, using a clinician referral or self-referral benefit.

Likewise, about half (45 percent) of patients who received chiropractic care accessed that care through their health plan. The remainder of patients went outside the health plan to access these services, or used a combination of health plan and outside resources to access the services.

The majority of the patients in the study (71 percent) were women, and the mean age was 61. Common complaints included back pain, joint pain, arthritis, extremity, neck and muscle pain, and headache.

Patients completed the survey online or by mail. It included 17 questions about the type of pain patients experienced, and their use of acupuncture, chiropractic care, and other alternative and complementary therapies.

The survey was administered as part of a study called RELIEF, which is comparing outcomes among chronic pain patients who receive chiropractic care and acupuncture, and those who do not.

Source: Kaiser Permanente/EurekAlert