Sponsor
Funding was received from the Ontario Chiropractic Association for this project.
Published In
Journal of Manipulative and Physiological Therapeutics
Document Type
Article
Publication Date
6-17-2019
Subjects
System theory, Opioids -- Therapeutic use, Pain -- Treatment
Abstract
Objective: The purpose of this investigation was to create a system dynamics (SD) model, including published data and required assumptions, as a tool for future research identifying the role of chiropractic care in the management of chronic, nonmalignant pain in a Canadian population. Methods: We present an illustrative case description of how we evaluated the feasibility of conducting a large-scale clinical trial to assess the impact of chiropractic care in mitigating excessive opioid use in Canada. We applied SD modeling using current evidence and key assumptions where such evidence was lacking. Modeling outcomes were highlighted to determine which potential factors were necessary to account for compelling study designs.
Results: Results suggest that a future clinical study diverting patients with nonmalignant musculoskeletal pain early to the chiropractic stream of care could be most effective. System dynamics modeling also highlighted design challenges resulting from unresearched assumptions that needed to be proxied for model completion. Assumptions included changing rates in opioid-associated deaths and rates of success in treatment management of addicted patients.
Conclusion: In this case, SD modeling identified current research gaps and strong contenders for appropriate followup questions in a clinical research domain, namely the role of chiropractic care in the management of chronic, nonmalignant pain in a Canadian population.
Locate the Document
DOI
10.1016/j.jmpt.2018.11.007
Persistent Identifier
https://archives.pdx.edu/ds/psu/28933
Citation Details
McGregor, M., Nielsen, A., Chung, C., Fillery, M. D., Wakeland, W., & Mior, S. (2019). System Dynamics to Investigate Opioid Use and Chiropractic Care for Chronic Musculoskeletal Pain. Journal of Manipulative and Physiological Therapeutics.
Description
© 2019 by National University of Health Sciences. This is an open access article under the CC BY-NC-ND license (https://creativecommons.org/licenses/by-nc-nd/4.0/).