Journal of the American Board of Family Medicine Sixth Annual Practice-based Research Network Theme Issue -They Just Keep Getting Better and Better
The Journal of the American Board of Family Medicine (Impact Factor: 1.98). 09/2011; 24(5):481-2. DOI: 10.3122/jabfm.2011.05.110213
We have quite a rich issue this month related to practice-based research networks (PBRNs)--reflections on where they have been, where they should go, how they should happen; lessons learned about recruiting physicians and patients and new research methods; and several clinical studies from existing PBRNs. We had an amazing number of manuscripts submitted this year for the PBRN issue; as a result, this is a powerful issue. Some are under revision for future issues of the Journal of the American Board of Family Medicine, just as we have some articles from PBRNs appearing in most issues. PBRNs have deepened the family medicine research tradition. The importance of primary care research to build the evidence base of our clinical practice, plus the useful work building the methods of primary care research, distinguishes the pioneers in PBRNs. PBRNs are Health Improvement Networks and national treasures to be nurtured.
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ABSTRACT: Background: Chronic Low Back Pain (cLBP) costs the United States over 100 billion annually. Primary Study Objective: This study reports pain intensity, general health and functional disability outcomes after 4-weeks of chiropractic care for cLBP patients. Methods/Design: A prospective case series, nonrandomized, non-controlled, practice-based study. Setting: 22 private chiropractic practices in the US. Subjects: 131 adult cLBP patients, 68 males (53.5%), mean age of 46.75 with chief complaints of cLBP (LBP ≥ 3 months) with mean duration of 11 years. Intervention: Each patient received 6 office visits over a 4-week period with doctors following Directional Non-Force Technique (DNFT) chiropractic protocols. Outcome Measures: The Dartmouth COOP charts (general health), Modified Oswestry Disability Questionnaire (MODQ) (functional disability), and an 11-point Pain Intensity Numerical Rating Scale (PI-NRS) for pain. Results: The pre and post-care mean scores of COOP were 13.16 (95% CI 9.33 - 16.99, P < 0.01) and 10.52 (CI 6.98 - 14.06, P < 0.01) respectively, 20.06% improvement. The MODQ were 17.72 (CI 11.02 - 24.42, P < 0.01) and 8.92 (CI 2.30 - 15.54, P < 0.01), 49.66% improvement in functional disability. The PI-NRS was 18.18 (CI 12.26 - 24.10, P < 0.01) and 10.60 (CI 3.80 - 6.80, P < 0.01), improving 41.69%. Conclusions: Improvements appeared to be significant on general health, functional disability, and pain intensity after an intervention of 4-weeks with 6 visits of DNFT chiropractic care. These findings merit a randomized control trial of chiropractic versus a control group or other treatment modalities in the future.
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