Patient characteristics, screening use, and health education in a practice-based chiropractic network: Results from ICON II

The Integrated Chiropractic Outcomes Network (ICON) is a practice-based research network (PBRN). In this preliminary study, participating doctors of chiropractic (DC) collected data on each patient who presented in their office during one designated day, modeled on the National Ambulatory Medical Care Survey (NAMCS), which only surveys medical and osteopathic physicians. Chief complaints, screening procedures, diagnosis, and health education engagement were assessed in 21 U.S. chiropractic practices. 530 patient visits were captured from 27 DCs. The most common complaint was back pain, and over 80% were established patients. Ordering of screenings on the day of the visit was low, including radiography (4%). Most patients paid with private insurance (61%). Nearly half (49%) presented for a new complaint and only 4% for preventive care. 10.5% of the patients used tobacco and over 65% were overweight or obese. Although physical activity/exercise was suggested to over 60%, only 23% of all patients and 28% of obese patients were given advice on diet. Only 9.8% of tobacco users were offered cessation advice that day. The sample represents members of a PBRN and is not necessarily representative of all DCs. Health education opportunities may be being overlooked among these providers, although advice may have been rendered on previous or subsequent visits. Additional investigation into methods to better integrate health education among these providers may be warranted. Methods to encourage DCs to adopt health promotion and disease prevention advising guidelines are also warranted.