Index to Chiropractic Literature
Index to Chiropractic Literature
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ID 28155
  Title Assessing documentation of delivery of self-management strategies in Veterans Health Administration chiropractic consultation visits
URL https://journal.parker.edu/article/123228-assessing-documentation-of-delivery-of-self-management-strategies-in-veterans-health-administration-chiropractic-consultation-visits
Journal J Contemp Chiropr. 2024 ;7(1):121-131
Author(s)
Subject(s)
Peer Review Yes
Publication Type Article
Abstract/Notes

Objective: The purpose of this study was to assess the frequency with which Veterans Health Administration (VHA) chiropractors document providing self-management strategies (SMS) to patients, and the degree to which patient visit characteristics are associated with delivery of SMS.

Methods: This analysis was part of a larger quality improvement project. A random sample of 1,000 on-station VHA chiropractic initial visits occurring from 10/01/2017 to 09/30/2018 in patients with no such visits in the prior 12 months was identified. Visit characteristics were identified and abstracted from VHA national electronic health record (EHR) data using structured data queries and manual chart review. The primary outcome of interest was documentation of delivery of SMS. The type of SMS delivered was also assessed. Other variables identified included patient demographics as well documented diagnoses and treatments. Multivariable logistic regression was used to determine associations between visit characteristics and documented delivery of SMS.

Results: There were 978 initial visits eligible for assessment. Documented delivery of any SMS was present in 44.1% of initial visits, with advice to remain active (18.0%) and use of heat or ice (15.8%) being the most common types of SMS delivered. Documented treatment with therapeutic exercise (aOR: 6.14; CI: 4.47-8.43), modalities (aOR: 2.46; CI: 1.54-3.91), other manual therapies (aOR: 1.41; CI: 1.04-1.92), and acupuncture/dry needling (aOR: 0.50; CI: 0.27-0.91) were significantly associated with delivery of SMS, while chiropractic manipulative therapy was not (aOR: 0.92; CI: 0.66-1.27). The presence of three diagnoses (aOR: 1.85; CI: 1.03-3.33), but not other counts of diagnoses or demographic characteristics, was significantly associated with delivery of SMS.

Conclusion: Documentation of delivery of SMS was present in 44% of initial VHA chiropractic visits. More work is needed to better understand documented delivery of SMS over the course of a complete episode of care and associations with patient outcomes.

Author keywords: Chiropractic; Veterans Health; Self-Management; Medical Documentation

This abstract is reproduced with the permission of the publisher. Click on the above link for free full text.

 
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