The use of alternative therapies or complementary medicine among patients referred to secondary care Spine department: prevalence, perceived needs, and clinical factors associated with alternative medicine use for spinal pain
Within a consecutive population presenting spinal pain, disease, or spine-related disability and referred to secondary care assessment in the Region of Southern Denmark, the following research questions are answered:
• The extent of alternative therapies or complementary medicine used within one year prior to referral
• Types of alternative therapies or complementary medicine used
• The association between the tendency towards the use of alternative therapies or complementary medicine, and the spine-related diagnosis, bio-psycho-social, and clinical findings
• The reasons for seeking alternative therapies or complementary medicine, and whether these are associated with the spine- related diagnosis
In spine medicine, the established treatment is supplemented by alternative therapies or complementary medicine. Intolerant pain, inaccessible doctors, experiences of lacking empathy, or time pressure in consultations in the established health care system are examples of motives for using alternative therapies.
A desire for general well-being or complementary treatment to the treatment offered in the established health care system, or lack of confidence in this treatment further increases the tendency to seek out alternative therapies.
Previous studies are predominantly done on patients in the primary sector, which indicates study populations with less pain or functional impairment. Typically, the spine patient in the secondary sector presents more complex symptoms and possibly a longer medical history, and as such, the personal and socio-economic costs are extensive.
An important premise for clinical research is to contribute to knowledge within the precision medicine. This study provides knowledge to the cross-sectoral management of spine patients in the Region of Southern Denmark and comparable populations through an increased understanding of the patients who use alternative therapies or complementary medicine.
Description of the cohort
The study population consists of patients with spinal pain or disease, and/or spine-related disability referred to elective secondary care assessment in the Region of Southern Denmark.
All patients are 18 years or older, and master Danish in writing and speaking. Patients are referred from general practice, chiropractors, or secondary care, primarily within the Region of Southern Denmark.
Patients have non-tractable pain, or activity-limiting disabilities despite conservative treatment, which qualify for referral to the Spine Center.
Patients with a diagnosis within one of the following groups will qualify for participation: Degenerative cervical or lumbar stenosis, Cervical or lumbar disc herniation, Non-specific cervical or lumbar pain, Spinal pain following trauma or chronic, complex pain.
Data and biological material
Data will be collected from Patient-Reported Outcome measures as used at the Spine Center, the Electronic Patient Journal, and a study-specific questionnaire. Sex, age, marital status, smoking habits, physical activity level (categories 1-4), Oswestry Disability Index, EuroQoL, Visual Analog Scale (spine and extremities, respectively), duration of pain, spinal pain trajectories, educational level, labor market attachment, ICD-10 diagnosis as established after assessment at the Spine Center, whether and which type of alternative therapies or complementary medicine has been used within 12 months prior to referral to the Spine Center, and the reason for seeking alternative therapies or complementary medicine.
The specific questions regarding the use of alternative therapies or complementary medicine are based on the examination of well-being, health, and illness among adults in the general population in the Region of Southern Denmark 2017
(Jensen HD, M.; Ekholm, O.; Christensen, AI.; Kristensen, PL.; Gårn, A. et al. Hvordan har du det? Trivsel, sundhed og sygdom blandt voksne i region Syddanmark 2017. Region Syddanmark; 2018.)