Primary care physicians, acupuncture and chiropractic clinicians, and chronic pain patients: a qualitative analysis of communication and care coordination patterns.

Publisher: BioMed Central Country of Publication: England NLM ID: 101088661 Publication Model: Electronic Cited Medium: Internet ISSN: 1472-6882 (Electronic) Linking ISSN: 14726882 NLM ISO Abbreviation: BMC Complement Altern Med Subsets: MEDLINE

Original Publication: London : BioMed Central, [2001-2019]

Acupuncture Therapy* ; Chiropractic* ; Delivery of Health Care, Integrated* ; Physician-Patient Relations* ; Physicians, Primary Care*; Chronic Pain/*therapy; Case Management ; Health Care Surveys ; Health Communication ; Humans ; Referral and Consultation

Background: A variety of people, with multiple perspectives, make up the system comprising chronic musculoskeletal pain (CMP) treatment. While there are frequently problems in communication and coordination of care within conventional health systems, more opportunities for communicative disruptions seem possible when providers use different explanatory models and are not within the same health management system. We sought to describe the communication system surrounding the management of chronic pain from the perspectives of allopathic providers, acupuncture and chiropractor (A/C) providers, and CMP patients.
Methods: We collected qualitative data from CMP patients (n = 90) and primary care physicians (PCPs) (n = 25) in a managed care system, and community acupuncture and chiropractic care providers (n = 14) who received high levels of referrals from the system, in the context of a longitudinal study of CMP patients' experience.
Results: Multiple points of divergence and communicative barriers were identified among the main stakeholders in the system. Those that were most frequently mentioned included issues surrounding the referral process (requesting, approving) and lack of consistent information flow back to providers that impairs overall management of patient care. We found that because of these problems, CMP patients were frequently tasked and sometimes overwhelmed with integrating and coordinating their own care, with little help from the system.
Conclusions: Patients, PCPs, and A/C providers desire more communication; thus systems need to be created to facilitate more open communication which could positively benefit patient outcomes.

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R01 AT005896 United States AT NCCIH NIH HHS

Date Created: 20160127 Date Completed: 20160913 Latest Revision: 20181113

20221213

PMC4727288

10.1186/s12906-016-1005-4

26810302