Veteran response to dosage in chiropractic therapy (VERDICT): Study protocol of a pragmatic randomized trial for chronic low back pain

Cynthia R. Long; Anthony J. Lisi; Robert D. Vining; Robert B. Wallace; Stacie A. Salsbury; Zacariah K. Shannon; Stephanie Halloran; Amy L. Minkalis; Lance Corber; Paul G. Shekelle; Erin E. Krebs; Thad E. Abrams; Jon D. Lurie; Christine M. Goertz

doi:10.1093/PM/PNAA289

Veteran response to dosage in chiropractic therapy (VERDICT): Study protocol of a pragmatic randomized trial for chronic low back pain

Cynthia R. Long, Anthony J. Lisi, Robert D. Vining, Robert B. Wallace, Stacie A. Salsbury, Zacariah K. Shannon, Stephanie Halloran, Amy L. Minkalis, Lance Corber, Paul G. Shekelle, Erin E. Krebs, Thad E. Abrams, Jon D. Lurie, Christine M. Goertz

Medicine - Veteran's Administration Medical Center

Research output: Contribution to journal › Article › peer-review

6 Scopus citations

Abstract

Background. Low back pain is a leading cause of disability in veterans. Chiropractic care is a well-integrated, nonpharmacological therapy in Veterans Affairs health care facilities, where doctors of chiropractic provide therapeutic interventions focused on the management of low back pain and other musculoskeletal conditions. However, important knowledge gaps remain regarding the effectiveness of chiropractic care in terms of the number and frequency of treatment visits needed for optimal outcomes in veterans with low back pain. Design. This pragmatic, parallel-group randomized trial at four Veterans Affairs sites will include 766 veterans with chronic low back pain who are randomly allocated to a course of low-dose (one to five visits) or higher-dose (eight to 12 visits) chiropractic care for 10 weeks (Phase 1). After Phase 1, participants within each treatment arm will again be randomly allocated to receive either monthly chiropractic chronic pain management for 10 months or no scheduled chiropractic visits (Phase 2). Assessments will be collected electronically. The Roland Morris Disability Questionnaire will be the primary outcome for Phase 1 at week 10 and Phase 2 at week 52. Summary. This trial will provide evidence to guide the chiropractic dose in an initial course of care and an extended-care approach for veterans with chronic low back pain. Accurate information on the effectiveness of different dosing regimens of chiropractic care can greatly assist health care facilities, including Veterans Affairs, in modeling the number of doctors of chiropractic that will best meet the needs of patients with chronic low back pain.

Original language	English (US)
Pages (from-to)	S37-S44
Journal	Pain Medicine (United States)
Volume	21
DOIs	https://doi.org/10.1093/PM/PNAA289
State	Published - 2020

Bibliographical note

Funding Information:
Funding sources: This work was supported by the National Institutes of Health (NIH) through cooperative agreement UG3/UH3AT009761 from the National Center for Complementary and Integrative Health (NCCIH) and the Office of Research on Women’s Health and by cooperative agreement U24AT009769 from the NCCIH and with resources and facilities of the Department of Veterans Affairs.

Funding Information:
Supplement sponsorship: This article appears as part of the supplement entitled “NIH-DOD-VA Pain Management Collaboratory (PMC)”. This supplement was made possible by Grant Number U24 AT009769 from the National Center for Complementary and Integrative Health (NCCIH), and the Office of Behavioral and Social Sciences Research (OBSSR). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NCCIH, OBSSR, and the National Institutes of Health.

Publisher Copyright:
© The Author(s) 2020. Published by Oxford University Press on behalf of the American Academy of Pain Medicine. All rights reserved.

Keywords

Chiropractic
Low Back Pain
Nonpharmacologic
Pain Management
Pragmatic Clinical Trial
Veteran

Publisher link

10.1093/PM/PNAA289

Find It

Find It at U of M Libraries

Cite this

Long, C. R., Lisi, A. J., Vining, R. D., Wallace, R. B., Salsbury, S. A., Shannon, Z. K., Halloran, S., Minkalis, A. L., Corber, L., Shekelle, P. G., Krebs, E. E., Abrams, T. E., Lurie, J. D., & Goertz, C. M. (2020). Veteran response to dosage in chiropractic therapy (VERDICT): Study protocol of a pragmatic randomized trial for chronic low back pain. Pain Medicine (United States), 21, S37-S44. https://doi.org/10.1093/PM/PNAA289

Long, CR, Lisi, AJ, Vining, RD, Wallace, RB, Salsbury, SA, Shannon, ZK, Halloran, S, Minkalis, AL, Corber, L, Shekelle, PG, Krebs, EE, Abrams, TE, Lurie, JD & Goertz, CM 2020, 'Veteran response to dosage in chiropractic therapy (VERDICT): Study protocol of a pragmatic randomized trial for chronic low back pain', Pain Medicine (United States), vol. 21, pp. S37-S44. https://doi.org/10.1093/PM/PNAA289

@article{23e56b5e831f48b3b197b7da2724e76a,

title = "Veteran response to dosage in chiropractic therapy (VERDICT): Study protocol of a pragmatic randomized trial for chronic low back pain",

abstract = "Background. Low back pain is a leading cause of disability in veterans. Chiropractic care is a well-integrated, nonpharmacological therapy in Veterans Affairs health care facilities, where doctors of chiropractic provide therapeutic interventions focused on the management of low back pain and other musculoskeletal conditions. However, important knowledge gaps remain regarding the effectiveness of chiropractic care in terms of the number and frequency of treatment visits needed for optimal outcomes in veterans with low back pain. Design. This pragmatic, parallel-group randomized trial at four Veterans Affairs sites will include 766 veterans with chronic low back pain who are randomly allocated to a course of low-dose (one to five visits) or higher-dose (eight to 12 visits) chiropractic care for 10 weeks (Phase 1). After Phase 1, participants within each treatment arm will again be randomly allocated to receive either monthly chiropractic chronic pain management for 10 months or no scheduled chiropractic visits (Phase 2). Assessments will be collected electronically. The Roland Morris Disability Questionnaire will be the primary outcome for Phase 1 at week 10 and Phase 2 at week 52. Summary. This trial will provide evidence to guide the chiropractic dose in an initial course of care and an extended-care approach for veterans with chronic low back pain. Accurate information on the effectiveness of different dosing regimens of chiropractic care can greatly assist health care facilities, including Veterans Affairs, in modeling the number of doctors of chiropractic that will best meet the needs of patients with chronic low back pain.",

keywords = "Chiropractic, Low Back Pain, Nonpharmacologic, Pain Management, Pragmatic Clinical Trial, Veteran",

author = "Long, {Cynthia R.} and Lisi, {Anthony J.} and Vining, {Robert D.} and Wallace, {Robert B.} and Salsbury, {Stacie A.} and Shannon, {Zacariah K.} and Stephanie Halloran and Minkalis, {Amy L.} and Lance Corber and Shekelle, {Paul G.} and Krebs, {Erin E.} and Abrams, {Thad E.} and Lurie, {Jon D.} and Goertz, {Christine M.}",

note = "Funding Information: Funding sources: This work was supported by the National Institutes of Health (NIH) through cooperative agreement UG3/UH3AT009761 from the National Center for Complementary and Integrative Health (NCCIH) and the Office of Research on Women{\textquoteright}s Health and by cooperative agreement U24AT009769 from the NCCIH and with resources and facilities of the Department of Veterans Affairs. Funding Information: Supplement sponsorship: This article appears as part of the supplement entitled “NIH-DOD-VA Pain Management Collaboratory (PMC)”. This supplement was made possible by Grant Number U24 AT009769 from the National Center for Complementary and Integrative Health (NCCIH), and the Office of Behavioral and Social Sciences Research (OBSSR). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NCCIH, OBSSR, and the National Institutes of Health. Publisher Copyright: {\textcopyright} The Author(s) 2020. Published by Oxford University Press on behalf of the American Academy of Pain Medicine. All rights reserved.",

year = "2020",

doi = "10.1093/PM/PNAA289",

language = "English (US)",

volume = "21",

pages = "S37--S44",

journal = "Pain Medicine (United States)",

issn = "1526-2375",

publisher = "Wiley-Blackwell",

}

TY - JOUR

T1 - Veteran response to dosage in chiropractic therapy (VERDICT)

T2 - Study protocol of a pragmatic randomized trial for chronic low back pain

AU - Long, Cynthia R.

AU - Lisi, Anthony J.

AU - Vining, Robert D.

AU - Wallace, Robert B.

AU - Salsbury, Stacie A.

AU - Shannon, Zacariah K.

AU - Halloran, Stephanie

AU - Minkalis, Amy L.

AU - Corber, Lance

AU - Shekelle, Paul G.

AU - Krebs, Erin E.

AU - Abrams, Thad E.

AU - Lurie, Jon D.

AU - Goertz, Christine M.

N1 - Funding Information: Funding sources: This work was supported by the National Institutes of Health (NIH) through cooperative agreement UG3/UH3AT009761 from the National Center for Complementary and Integrative Health (NCCIH) and the Office of Research on Women’s Health and by cooperative agreement U24AT009769 from the NCCIH and with resources and facilities of the Department of Veterans Affairs. Funding Information: Supplement sponsorship: This article appears as part of the supplement entitled “NIH-DOD-VA Pain Management Collaboratory (PMC)”. This supplement was made possible by Grant Number U24 AT009769 from the National Center for Complementary and Integrative Health (NCCIH), and the Office of Behavioral and Social Sciences Research (OBSSR). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NCCIH, OBSSR, and the National Institutes of Health. Publisher Copyright: © The Author(s) 2020. Published by Oxford University Press on behalf of the American Academy of Pain Medicine. All rights reserved.

PY - 2020

Y1 - 2020

N2 - Background. Low back pain is a leading cause of disability in veterans. Chiropractic care is a well-integrated, nonpharmacological therapy in Veterans Affairs health care facilities, where doctors of chiropractic provide therapeutic interventions focused on the management of low back pain and other musculoskeletal conditions. However, important knowledge gaps remain regarding the effectiveness of chiropractic care in terms of the number and frequency of treatment visits needed for optimal outcomes in veterans with low back pain. Design. This pragmatic, parallel-group randomized trial at four Veterans Affairs sites will include 766 veterans with chronic low back pain who are randomly allocated to a course of low-dose (one to five visits) or higher-dose (eight to 12 visits) chiropractic care for 10 weeks (Phase 1). After Phase 1, participants within each treatment arm will again be randomly allocated to receive either monthly chiropractic chronic pain management for 10 months or no scheduled chiropractic visits (Phase 2). Assessments will be collected electronically. The Roland Morris Disability Questionnaire will be the primary outcome for Phase 1 at week 10 and Phase 2 at week 52. Summary. This trial will provide evidence to guide the chiropractic dose in an initial course of care and an extended-care approach for veterans with chronic low back pain. Accurate information on the effectiveness of different dosing regimens of chiropractic care can greatly assist health care facilities, including Veterans Affairs, in modeling the number of doctors of chiropractic that will best meet the needs of patients with chronic low back pain.

AB - Background. Low back pain is a leading cause of disability in veterans. Chiropractic care is a well-integrated, nonpharmacological therapy in Veterans Affairs health care facilities, where doctors of chiropractic provide therapeutic interventions focused on the management of low back pain and other musculoskeletal conditions. However, important knowledge gaps remain regarding the effectiveness of chiropractic care in terms of the number and frequency of treatment visits needed for optimal outcomes in veterans with low back pain. Design. This pragmatic, parallel-group randomized trial at four Veterans Affairs sites will include 766 veterans with chronic low back pain who are randomly allocated to a course of low-dose (one to five visits) or higher-dose (eight to 12 visits) chiropractic care for 10 weeks (Phase 1). After Phase 1, participants within each treatment arm will again be randomly allocated to receive either monthly chiropractic chronic pain management for 10 months or no scheduled chiropractic visits (Phase 2). Assessments will be collected electronically. The Roland Morris Disability Questionnaire will be the primary outcome for Phase 1 at week 10 and Phase 2 at week 52. Summary. This trial will provide evidence to guide the chiropractic dose in an initial course of care and an extended-care approach for veterans with chronic low back pain. Accurate information on the effectiveness of different dosing regimens of chiropractic care can greatly assist health care facilities, including Veterans Affairs, in modeling the number of doctors of chiropractic that will best meet the needs of patients with chronic low back pain.

KW - Chiropractic

KW - Low Back Pain

KW - Nonpharmacologic

KW - Pain Management

KW - Pragmatic Clinical Trial

KW - Veteran

UR - http://www.scopus.com/inward/record.url?scp=85098251662&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85098251662&partnerID=8YFLogxK

U2 - 10.1093/PM/PNAA289

DO - 10.1093/PM/PNAA289

M3 - Article

C2 - 33313732

AN - SCOPUS:85098251662

SN - 1526-2375

VL - 21

SP - S37-S44

JO - Pain Medicine (United States)

JF - Pain Medicine (United States)

ER -

Veteran response to dosage in chiropractic therapy (VERDICT): Study protocol of a pragmatic randomized trial for chronic low back pain

Abstract

Bibliographical note

Keywords

Publisher link

Find It

Other files and links

Fingerprint

Cite this