Collaborative Care for Older Adults With Back Pain

As America ages, cost-effective care for chronic diseases, such as low back pain, becomes more important. Although estimates vary, 70-85% of Americans will suffer from back pain at some point in their lives. Back pain is well established as one of the most common reasons for seeking care from a medical doctor.

The American public also turns to alternative medicine providers, such as doctors of chiropractic, for back pain care. However, few clinical examples and little scientific evidence exist of care coordination between these two provider groups in general, and none that specifically target older adults above the age of 65.

The purpose of the collaborative back care for Older Adults with Back Pain is to evaluate the clinical effectiveness and feasibility of a collaborative care model through a pragmatic, prospective pilot trial conducted with 120 older adults over the age of 65 with low back pain of at least 1-month duration.

In this trial, participants will be randomized to 3-parallel treatment arms: a) conventional medical care, b) unlinked conventional medical and chiropractic care, and c) co-management model including conventional medical and chiropractic care. Participants in all three groups will receive up to 12 weeks of usual back pain treatment from medical doctors or doctors of osteopathy.

Participants in two treatment groups additionally will receive up to 12 weeks of usual chiropractic care for back pain from doctors of chiropractic. Outcomes including pain, disability, and secondary outcomes will be measured at 1, 2, and 3 months (primary endpoint) with follow-up assessments completed by telephone at 6, 9, and 12 months