Comparison of Health Counselling Scores of Chiropractic Patients Receiving Interprofessional Collaborative Care and Usual Care

Purpose: Co-managed patients tend to have more chronic conditions and worse health related quality of life scores, suggesting a role for chiropractors. We compared health counselling scores in chiropractic patients receiving interprofessional collaborative care (IPC) and those that did not.

Main outcome: The Counselling Scale of Primary Care Assessment Survey (Scale).

Methods: Cross-sectional design. Data were collected from 2067 patients receiving IPC involving chiropractors and physicians (study) and from 530 patients of chiropractors who were not involved (reference).

Results: Patients in the study group had longer pain duration, lower income levels, and shorter length of provider-relationship than the reference group. There was a substantial difference (p<.001) in Scale scores between the two groups. The majority of reference and study patients reported receiving advice on exercise (83.2% and 76.2%), spine care (79.7% and 91.2%), stress (52.9% and 70.4%), and diet (30.1% and 43.1%), respectively. A minority of patients in both groups received advice on smoking, alcohol use and seat belt use. Almost 90 to 95% of patients in both groups reported taking advice on exercise, stress, and back/spine care; however, fewer in the other categories acted on the advice.

Conclusion: The differences noted between the groups may have been related to the longer chiropractor-patient relationships, reimbursement model, chiropractors' familiarity with patients' underlying conditions, or their related subject knowledge. Chiropractors participating in IPC could become more actively involved in providing advice to encourage healthier living, especially in consideration of the percentage of patients reporting following through with the advice.