Fast Facts

Stacie A. Salsbury, PhD RN


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Topics in Integrative Health Care 2016, Vol. 6(3)   ID: 6.3004

Published on
January 8, 2016
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Readers are welcome to contribute to Fast Facts. Please include the original abstract (with citation) that is the source of your contribution. Contributors’ names will be included along with the item.

Definitions of integrative medicine (IM) vary making it difficult to compare components and findings from studies assessing the efficacy and safety of IM. This literature review provides a suggested checklist for reporting IM studies that includes items on rationale, evidence, safety, design, outcome measures, diagnoses, personnel including practitioners and division of care, clinical setting, interventions including regimen for treatment, self-care, and processes of integration, and results including harms and costs. A link to the article is provided:

Hu X-Y, Lorenc A, Kemper K, Liu J-P, Adams J, Robinson N. Defining integrative medicine in narrative and systematic reviews: a suggested checklist for reporting. Eur J Integr Med 2015; 7(1), 76-84.

This task force identified core competencies for entry-level primary care physicians in the area of integrative pain care. The general patient pain care competency emphasized the use of multiple pain paradigms, interprofessional team approaches, and compassionate patient care. The interpersonal and communication skills competency highlighted effective communication with patients, families and other healthcare providers to set realistic expectations and achieve optimal outcomes. The medical knowledge for assessment competency encourages biopsychosocial and functional evaluations of pain for accurate diagnoses. The medical knowledge for management competency develops a comprehensive and goal-oriented treatment plan that incorporates pharmacological, non-pharmacological and integrative modalities. The practice-based learning and improvement competency highlights critical appraisal skills and practice-level continuous quality improvement initiatives. Lastly, the professional competency demonstrates sensitivity to patient needs and appreciation for interprofessional approaches to pain management. While designed to guide primary care residency programs, the competencies also may benefit educational programs for complementary, alternative and integrative providers. A link to the article is provided:

Tick H, Chauvin SW, Brown M, Haramati A. Core competencies in integrative pain care for entry-level primary care physicians. Pain Med 2015; early view.

This cross-sectional study used Medicare claims data to explore the relationship between the regional supply of chiropractors and the number of visits to primary care providers by older adults for spine pain. The regional supply of chiropractors was highest in the Midwest US, and lowest in the South US. A strong association between the supply of chiropractors and the supply of family medicine providers was apparent, bringing into question whether chiropractors are practicing in locations that improve patients’ overall access to healthcare. Modest associations were calculated for greater supplies of chiropractors and fewer visits to primary care providers (both internal medicine and family medicine doctors). These findings suggest that chiropractic care may be used as a substitute for medical care rather than as additive care by older adults with spine pain. A link to the free full text article is provided:

Davis MA, Yakusheva O, Gottlieb DJ, Bynum JPW. Regional supply of chiropractic care and visits to primary care physicians for back and neck pain. J Am Board Fam Med 2015; 28(4), 481-490.

In a cross-sectional survey of 150 adults (74% Hispanic) who received healthcare in a community health center, 63% used at least 1 type of complementary or alternative (CAM) therapy in the past year, with vitamins/supplements (48%), herbal medicine (43%), nutritional therapy (39%), massage (36%), meditation or relaxation (23%), chiropractic (16%), acupuncture (11%), and yoga (11%) the most commonly used therapies. Reasons for using CAM included weight loss, sleep, diabetes, high blood pressure, or indigestion among other reasons. Most patients (72%) would like CAM therapies offered at the community health center; 61% were comfortable discussing CAM with their medical providers; and 47% recommended that their physicians ask patients about their current CAM use. A link to the free full text article is provided:

Ho DV, Nguyen J, Liu MA, Nguyen AL, Kilgore DB. Use of and interest in complementary and alternative medicine by Hispanic patients of a community health center. J Am Board Fam Med 2015; 28(2), 175-183.

This qualitative study conducted with 26 patients in Canada explored their perceptions of informed consent for chiropractic treatment. A 4-stage framework identified informed consent as an ongoing process for patients rather than as a discrete act. Patients’ perceived ideas about the risks involved in chiropractic care, their evaluations of the perceived competence of the chiropractor, the interactive process of discussing risks and signing a consent form, and a patient-practitioner feedback loop allowed patients to weigh the possible risks and benefits of receiving chiropractic care. Clinicians are encouraged to engage in active listening of patient concerns regarding the risks of chiropractic care in general, as well as the discomforts and safety of specific treatments during patient-doctor interactions. A link to the free full text article is provided:

Winterbottom M, Boon H, Mior S, Facey M. Informed consent for chiropractic care: comparing patients’ perceptions to the legal perspective. Man Ther 2015; 10(3), 463-468.

Contributed by

Stacie A. Salsbury, PhD RN

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