Work-site Evaluation of Acupuncture for Lower Back Pain
Abstract
Back pain is the leading cause of job related disability among United States employers. Numerous studies have demonstrated the limited impact of usual care to alleviate pain, restore an employee to active status, or to deliver care in a cost-effective manner. Therefore this proposal is to develop and implement an "Integrative Medicine" intervention to demonstrate more positive clinical and cost outcomes then the current standard of care. This intervention will be delivered in two Ford Motor Company Clinics to a total of 80 employees and compared to 80 employees receiving the usual care delivered in these same clinics.
The Integrative Medicine intervention will consist of an intensive six week program involving three major components: (a) Traditional Chinese Acupuncture, (b) patient educational materials dealing with acute back pain supplemented by individualized patient education services delivered via a toll free telephone number, and (c) the standard Ford Clinic back pain care. These enhanced services will be coordinated onsite at the participating Ford Clinics by a trained nurse case-manager working closely with the Complementary Medicine Program of the University of Maryland School of Medicine physicians and researchers.
The intervention will be evaluated by an array of pain, functioning, productivity, medical utilization, and quality of life outcomes capable of being administered over the telephone in order to reduce experimental attrition. The primary hypothesis that will be tested is that an integrative medicine intervention will be more effective than usual care in terms of both clinical and economic outcomes.
This project will constitute the first controlled test of the feasibility of implementing an integrative medical clinic within a corporate workplace. As such, it is not a test of the efficacy of the individual components of this integrative approach, but rather a carefully controlled evaluation of the overall comprehensive, integrative approach that, if successful, would have important financial and policy implications for the Ford Motor Company. Given this objective, the study design itself will be tailored to the realities of the corporate workplace by emphasizing the maintenance of participant satisfaction and the minimization of participant burden.
Demonstrating a positive impact upon such a pervasive problem would be a direct benefit to the Ford Motor Company as well as the community at large. It would also constitute a major professional contribution and possess national media significance. In all such dissemination arenas, the Ford Motor Company will be acknowledged for its funding and implementation of this major innovation in low back treatment.
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