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CCGPP Expanded Study Needs YOUR Support!

Wednesday, June 21, 2017   (0 Comments)
Posted by: Sheri Ryan
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CCGPP EXPANDED STUDY - SUPPORT NEEDED

Once again the Clinical Compass (CCGPP) has provided our profession with pertinent information to help support our doctors in the field. Please review the information below and seriously consider their request.With each of us doing a little, we can accomplish a lot.

Don M. Cross, DC
COCSA President

Dear State Association Leader:

It is next to impossible to pick up a newspaper, magazine or watch a news program without finding a story on the growing epidemic of opioid abuse. Far too often opioid abuse starts with legally prescribed opioids for non-cancerous spinal pain. Chances are you have patients in your practice who were prescribed opioids for conditions you successfully manage day in and day out! The sad thing is there are many people in our communities who never find their way into the office of a doctor of chiropractic and end up with a prescription(s) for a highly addictive drug. Anecdotally, many of the patients we see in our practice have been able to avoid prescriptive medications all together or at least significantly reduce the amount of medication needed when they receive chiropractic care. The big question is can we as a profession demonstrate that chiropractic management can indeed reduce the utilization of opioids?

Thanks to a very generous grant from the Michigan Chiropractic Foundation the Clinical Compass (CCGPP) funded a study by Dr. James Whedon which attempted to address this question. The Association between Utilization of Chiropractic Services, Use of High Risk Drugs, and Risk of Adverse Drug Events was presented in poster form at a press briefing organized by The Foundation for Chiropractic Progress (F4CP), to launch the National Campaign, “Save Lives. Stop Opioid Abuse. Choose Chiropractic” at the National Press Club in Washington, DC on March 14th. The authors are currently preparing two manuscripts for peer-review publication. This study utilized information from the New Hampshire All Payers Database (abstract poster enclosed) demonstrated that “the rate of opioid use was lower for recipients of chiropractic services (19%) as compared to non-recipients (35%). The likelihood of filling a prescription for opioids was 55% lower in the chiropractic recipient cohort (OR 0.45; 95% CI 0.40, 0.47). Average annual per-person charges for opioid prescription fills were 78% lower for recipients of chiropractic services as compared to non-recipients.”Association between Utilization of Chiropractic Services and Use of Prescription Opioids among Patients with Low Back Painby James Whedon DC, MS, Southern University of Health Sciences, Whittier, CA.

I’m sure you have seen the most recent American College of PhysiciansCouncil on Chiropractic Guidelines & Practice Parametersclinical practice guideline recommending the use of non-pharmacologic treatments for acute, subacute and chronic low back pain, inclusive of manipulation, the most recent JAMA article and JAMA editorial by Deyo essentially endorsing the use of manipulation and most recently the FDA’s recommendation of non-pharmacologic treatment of back pain. The science for the effectiveness for manipulation is there. Now, with Whedon’s work, we can draw direct statistical correlations that when a patient sees us, the probability of using addictive drugs is less. I don’t know that there is a better opportunity with a bigger potential impact for our profession right now. Timing is critically important. I would bet the PT’s (who do manipulation) and the osteopaths have got to be thinking the same thing.

Dr. Whedon has submitted a proposal for a larger study to evaluate health claims data from multiple northeastern states. According to the proposal, “with more voluminous and better quality data from other states, we expect to reproduce the striking results of the first study on a significantly larger scale. Rigorous analysis of claims data from multiple contiguous states promises to deliver results with robust external validity and generalizability, and potent implications for health policy. The resultant paper is expected to be a strong candidate for publication in a high-impact medical or health policy journal. The development of a large multi-state dataset can also be used as a platform for the conduct of other research with potential impact on health policy.”

As a profession, we must step up and fund this study and we must fund it yesterday! We are asking each state association to invest in this study and contribute between $0.50-$1.00 per month per association member. As always, we gratefully accept one time donations of any amount. Please bring this request to your board for consideration ASAP.

Sincerely,

Dr. Jay Greenstein                                 Dr. Jim McDaniel
Chair, Clinical Compass                         Vice Chair, Clinical Compass

CCGPP Letter dated 06/20/2017-for use with your state association Board

Enclosure-New Hampshire Opioid Study by Dr. James Whedon

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