The Effect of Chiropractor-informed Triage on Low Back Pain Patient Outcomes and Trajectories

NCT04923308 | Completed

• 1 other identifier: UQTR-2021-triage
• Study Type: observational
• Target: 118
• Locations: 1 country
• Sites: 1

Brief Summary

Almost everyone will have low back pain (LBP) at some point in their lives. LBP is a complex multifactorial condition for which diagnosis and clinical management remains a challenge. Factors such as wait times, delays in diagnosis or proper referral can result in Canadian patients having difficulty getting the care that they need. The overall objective of this project is to explore how chiropractors, who specialize in the diagnosis and clinical management of spinal conditions, can transform healthcare trajectories and improve the health of patients with LBP by integrating medical specialist team.To do so, patients with low back pain seeking medical care within the public health system will be first seen by chiropractors. Chiropractors will play a key role in identifying the type of low back pain and subsequently offering guidance to medical specialists with regard to the best treatment and management options that are currently recommended. Participating patients will be followed over a year while extensive health-related data will be collected and compared to non-triage patients with LBP.

Conditions

Low Back Pain; Triage

Keywords

Low back pain; triage; care pathways; chiropractor; pain; disability; health resources

Outcome Measures

Primary Outcomes (1)

• Change from baseline in back and leg pain intensity (current and past week)

  11-point numerical rating scale (NRS) :global measure of pain intensity anchored by two extremes of pain intensity ranging from 0 ('no pain') to 10 ('pain as bad as it could be').

  baseline, week 1, week 12, week 24 and 12 months follow-up

Secondary Outcomes (12)

• Diagnosis made by the specialist

  up to 4 weeks post-baseline assessment

• Number of requests for medical imaging

  over a one year period

• Number of requests for laboratory tests

  over a one year period

• Number of requests for medication prescriptions

  over a one year period

• Number of subsequent visits to the outpatient clinic or medical specialist

  over a one year period

Study Arms (2)

Intervention group

Other: Triage results disclosed

Control group

Other: Triage results undisclosed

Interventions

Triage results disclosed OTHER

Following the chiropractor triage assessment, the working diagnosis and risk stratification or referral need will be communicated to the specialist using a standardized clinical note, prior to the patient's consultation and without further discussion.

Intervention group

Triage results undisclosed OTHER

Following the chiropractor triage assessment, the working diagnosis and risk stratification or referral need will not be communicated to the specialist.

Control group

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

This study will involve individuals seeking medical consultation in the tertiary care public health system for an episode of LBP. The study will be conducted at the neurosurgery outpatient clinic affiliated to the Centre Intégré Universitaire de Santé et de Services Sociaux- Mauricie Centre du Québec (CIUSSS-MCQ; Trois-Rivières' regional healthcare organization). The CIUSSS-MCQ, established in 2015 as a result of the merger of 12 health and social services public institutions, totals 974 physicians, including 515 GPs. It serves a population of over 510,000 inhabitants, of which 83% are over 18 years of age (17).

You may qualify if:

• Being ≥ 18 years of age
• Being scheduled in the outpatient clinics with a primary complaint of LBP (either acute, chronic or recurring episodes), consistent with LBP definition (pain between the lower rib margins and the buttock creases, with or without associated symptoms in the lower limb(s)).
• Being able to comprehend and express oneself in French

You may not qualify if:

• Patients involved in litigation related to their LBP condition (i.e., worker's compensation, public automobile insurance plan or other litigations)

Sponsors & Collaborators

• Université du Québec à Trois-Rivières: lead

Study Sites (1)

Université du Québec à Trois-Rivières

Trois-Rivières, Quebec, G9A 5H7, Canada

Location

MeSH Terms

Conditions

Low Back Pain; Pain

Condition Hierarchy (Ancestors)

Back Pain; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Full professor

Study Record Dates

• First Submitted: June 2, 2021
• First Posted: June 11, 2021
• Study Start: July 6, 2021
• Primary Completion: November 27, 2024
• Study Completion: November 27, 2024
• Last Updated: March 28, 2025

Record last verified: 2025-03

Locations

CA (1)