Predictors of patient improvement after 30 days of chiropractic care

Introduction: Patients often receive chiropractic treatment for pain as part of their health plan benefits. Many patients receive care according to predetermined visit limits not related to their treatment need. This study explores the predictors of overall patient improvement after 30 days for patients with no preset benefit limits.

Methodology: Chiropractors affiliated with a health plan in the northeastern United States submitted treatment requests for patients with pain complaints. A total of 2,882 chiropractors requested 40,620 extensions of care beyond 30 days of treatment for 32,585 unique patients over a 3-year period. Information related to the patient was collected by the chiropractor, including a visual pain analogue score, functional index, work capacity, surgical history, previous care episodes, patient age, and patient gender. A logistic regression model was used to predict which factors where related to an overall improvement of greater than 50% for patients after 30 days of treatment.

Results: Patients who received care were predominantly female (60%) with a mean age of 42 years old. Predictors of overall improvement greater than 50% after 30 days of treatment included having a pain analogue score of less than 5 at baseline (p<.001), having symptoms for fewer than 3 weeks before the initial visit (p<.001), having been treated by the chiropractor in the past (p<.001), and having the chiropractor's initial treatment recommendation completely approved (p<.001).

Conclusions: This study suggests that certain patient-related, as well as provider-related factors may be associated with greater patient improvements resulting from short term chiropractor care.