| Background: There are very few studies to date dealing with cervical spinal manipulative therapy (SMT) for the treatment of acute neck pain. One of the primary reasons is that the duration of acute neck pain is short, forestalling attempts to carry out randomized clinical trials. Accordingly, we consider a practice-based research model an excellent approach to investigating this topic. This is because practicing chiropractors are able to recruit acute neck pain patients very early in the course of the condition and then begin treatment without delay related to a research protocol.
Objectives: The primary objective of this observational study is to assess the ability of the Palmer College of Chiropractic West practice based research network to reliably gather data concerning acute neck pain patients. Secondarily, the study may generate interpretable pilot data.
Methods: This study was reviewed and approved by the Institutional Review Board of the Palmer Center for Chiropractic Research. Ten local chiropractors in private practice were recruited to provide data on their management of patients with acute neck pain. They were to prospectively collect and report data on several specific outcome measures pertaining to their treatment of qualified patients. Chiropractors were recruited using several methods including a newsletter article, presentations at local chiropractic society meetings, referral from colleagues already in the study, and by personal contact from the investigators.
Results: The recruiting methods resulted in 38 chiropractors signing their names to an interest list. These doctors were mailed additional information about the study and a participation agreement that outlined the participating doctors’ involvement with the school. Unfortunately, most of the doctors did not return their signed participation agreements. Consequently, they were each contacted by telephone to determine their level of commitment and encourage their enrollment. Ultimately, 22 agreements were returned and these were the doctors included in the study. The 22 participating doctors were provided nicely printed certificates of participation and invited to an evening training session to provide them with an orientation on the study protocol and the questionnaires that would be used. Twelve doctors attended the session and the remainder were trained by telephone. Two of the participating chiropractors withdrew from the program prior to data collection, leaving 20 who were sent study questionnaires to use on their new acute neck pain patients. Without further prompting, 6 participants provided data on 22 patients. However, 14 did not provide any data and were contacted by email and then by telephone to ask why not. These doctors gave various reasons for not collecting data, but most simply forgot to implement the program into their practice routine. All 14 have recommitted, and we anticipate reaching our initial objective of 10 active participants.
Discussion : This study presents the recruitment process and early data collection performance of chiropractic doctors involved in a practice based research study. The frequent contact with the doctors, training in procedures, and the tools that were provided have been useful in reaching our objectives. Recruiting chiropractors into the study has been challenging, and good implementation and follow-through have been difficult, which is one of the reasons we have regularly contacted the participating doctors with instruction and encouragement.
Conclusions: The development of a practice-based research network has been somewhat problematic, which has resulted in the implementation of several remedial strategies. Moreover, this study does at least confirm the notion that a large commitment of time and energy is necessary to carry out a successful practice based research project. This abstract is reproduced with the permission of the publisher. |
