A feasibility study assessing a program of care for chiropractors managing spinal pain in Canadian Armed Forces personnel

Abstract

Introduction: Chronic back and lower and upper limb disorders are common and responsible for 42% of medical releases from the Canadian Armed Forces (CAF). Chiropractors care for CAF personnel off base, but collaboration with Canadian Forces Health Services (CFHS) varies among Canadian Forces Bases (CFBs). Developing a program of care (PoC) could address such variation. This study aimed to develop and assess the feasibility of implementing a PoC to improve chiropractors' communication with CFHS and delivery of spine care to active duty CAF personnel. Methods: This mixed-methods feasibility study involved two CFBs. Eligible participants included Medavie Blue Cross registered chiropractors, active duty CAF members with spinal pain, and CFHS personnel. Feasibility metrics included participation rates, attendance at meetings, completeness of clinical reports and patient outcome questionnaires, adherence to guidelines, and participants' experiences with study protocols and care. Data were analyzed descriptively and thematically. Results: Participants were 55% (11/20) of invited chiropractors and 85% (22/26) of referred CAF and invited CFHS personnel. All chiropractors and CFHS personnel attended on-base meetings. Training sessions, meetings, and educational materials enhanced understanding of military culture and treatment expectations. 98% of clinical reports and outcome questionnaires were completed, and practice guidelines were followed. Participants suggested that communication between chiropractors and CFHS personnel improved compared with prior experience. Discussion: Implementing a PoC that enhances communication with CFHS personnel and delivers evidence-based spine care to CAF members is feasible. Future work is needed to determine whether such care improves outcomes among CAF members with spinal pain.