Objective: to replicate questions from the National Ambulatory Medical Care Survey (NAMCS) in a sample of Doctors of Chiropractic (DCs) in a practice-based research network (PBRN) to assess the feasibility and appropriateness of the survey instrument for a larger study focusing on prevention and health promotion-related practices.
Methods: The study population consisted of volunteer DCs in the Integrative Chiropractic Outcomes Network (ICON) PBRN. DCs recorded data on each patient who presented in their office during one designated day. Data were collected on chief complaints, screening procedures, diagnosis, and health education advice.
Results: 530 patient visits were captured from 27 DCs in 21 practices. The most common complaint was back pain, and over 80% were established patients. Ordering of screenings on the day of the visit was infrequent, including radiography (4%). Most patients paid with private insurance (61%). Nearly half (49%) presented for a new complaint and only 4% for preventive care. 10.5% of the patients were recorded as tobacco users and over 65% were overweight or obese. Advice on physical activity/exercise was suggested to over 60% of patients. While specific advice on weight management was provided to only 11.5% of obese patients, 74% of obese patients received advice on diet, exercise or weight reduction. Only 9.8% of tobacco users were offered cessation advice that day.
Conclusions: Adaptations of the survey may be necessary to reflect chiropractic practice style, in which patients make multiple visits. Methods to encourage DCs to adopt health promotion and disease prevention advising guidelines may be warranted.
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