Back Pain Recognition Program: An Opportunity to Improve Quality Assurance; Integrate Best Practices; and Deliver High-Quality, Patient-Centered Care

A pilot study assessing patient-centred care in patients with chronic health conditions attending chiropractic practice

OBJECTIVES

The primary aim of this pilot study was to determine the feasibility of conducting a mixed- methods study assessing the extent patients with chronic health conditions perceive chiropractic care to be patient-centred.

DESIGN

A sequential mixed methods feasibility study with a quantitative priority.

SETTING

Two private chiropractic clinics in Calgary, Alberta, Canada.

MAIN OUTCOME MEASURES

Feasibility outcomes included pilot study participation, consent and completion rates. Demographic and health information and a modified version of the Patient Assessment of Chronic Illness Care (PACIC).

RESULTS

Over three weeks, 90 participants were recruited, 86 enrolled, and 78 provided complete data, with only one who commented on the clarity of paperwork. Included participants were on average 47.1 years of age and 60.3% were female. They had an average of 1.8 chronic conditions with 60% having chronic spinal pain. They reported seeing an average of 2.9 other health professionals for their chronic health condition and averaged 12.9 chiropractic visits in the past year. The average overall modified PACIC score was 3.29 on a 5-point scale. Higher scores were seen on the 'patient activation', 'delivery system design/decision support', and 'problem solving/contextual' subscales, with lower scores seen on the 'goal-setting/tailoring' and 'follow-up/coordination' subscales. Interview data generally supported those findings.

CONCLUSIONS

The pilot study results support the feasibility of the methods for a subsequent large-scale study. These preliminary results suggest that the degree of patient-centredness compares favourably to similar studies in primary medical care.