Back pain pro­ject wins award, helps cut opi­oid use

The Intelligencer (Belleville) - - FRONT PAGE - LUKE HENDRY THE INTELLIGENCER

A pi­lot pro­ject which has re­duced opi­oid use through chi­ro­prac­tic care has won an award from the As­so­ci­a­tion of Fam­ily Health Teams of On­tario.

The team from the Belleville Nurse Prac­ti­tioner- Led Clinic in Oc­to­ber won one of seven Bright Lights awards. On­tario’s Deputy Health Min­is­ter, Dr. Bob Bell, pre­sented it.

The awards hon­our projects which have im­proved pri­mary care through part­ner­ships and mak­ing the most of their re­sources.

Since Jan­uary 2015, clinic staff have taken part in On­tario’s Pri­mary Care Low Back Pain Pi­lot pro­ject. Funded by the health min­istry, it has stud­ied the use of in­ter­pro­fes­sional teams of health care work­ers to treat pa­tients with lower back pain.

Chi­ro­prac­tor Dr. Bruce Flynn said as the pro­ject pro­gressed, “The data was show­ing there was a ma­jor re­duc­tion in med­i­ca­tion use, in­clud­ing opi­oid med­i­ca­tions.

“The re­sults have been phe­nom­e­nal.”

The pro­gram is one of seven in On­tario. They in­te­grate such prac­ti­tion­ers as chi­ro­prac­tors, phys­io­ther­a­pists and ki­ne­si­ol­o­gists into other health or­ga­ni­za­tions. That, said Flynn, re­sults in closer work among pro­fes­sion­als as they treat pa­tients with a team ap­proach.

To­gether the seven pi­lot projects re­ported 83 per cent of pa­tients re­lied less upon pain med­i­ca­tion fol­low­ing treat­ment.

Ninety- three per cent said the qual­ity of their lives im­proved as a re­sult of hav­ing less pain.

Staff also recorded a 51 per cent de­cline in dis­abil­ity be­tween ini­tial ex­am­i­na­tion and re- ex­am­i­na­tion.

“My clients re­port much im­prove­ment — not only with pain con­trol but also en­ergy and func­tion,” a pro­ject pre­sen­ta­tion quoted nurse prac­ti­tioner Kristy Naulls as say­ing.

“It’s the in­te­gra­tion and work­ing to­gether of all the health team that’s cre­at­ing these great re­sults,” Flynn said. “I ex­pected good re­sults. I didn’t ex­pect some­one to quit opi­oids cold turkey.”

He said the pro­ject has also re­duced di­ag­nos­tic imag­ing and emer­gency- room vis­its for lower­back pain.

One Belleville pa­tient quoted in a clinic pre­sen­ta­tion said she’d had back pain for 11 years.

“I was tak­ing six Per­co­cet per day, along with six Tylenol No. 3,” she said. “After only a few ad­just­ments I started to feel so much bet­ter.

“I have elim­i­nated the Per­co­cet and Tylenol No. 3 and now have no pain,” she added.

Flynn said an­other pa­tient told him her use of opi­oid med­i­ca­tion for pain had caused kid­ney pro­grams, Flynn said, and she was still in pain.

“Peo­ple were bring­ing her food be­cause she couldn’t get out,” he re­called.

After treat­ment in the pi­lot pro­gram, he said, her kid­ney func­tion im­proved; she lost 50 lbs, and now walks from roughly Moira Street West to the Quinte Mall and be­yond.

“When I saw the im­prove­ments I said, ‘ We should open this up to more peo­ple,’” Flynn said. A part­ner­ship with the Belleville and Quinte West Com­mu­nity Health Cen­tre led to pa­tients from the cen­tre be­ing re­ferred to the pro­gram; they also worked with the health cen­tre’s phar­ma­cist.

Only pa­tients al­ready reg­is­tered with the clinic and with an­nual in­comes of no more than $ 35,000 are el­i­gi­ble for the pi­lot. The clinic is not cur­rently ac­cept­ing new pa­tients.

But for those al­ready reg­is­tered and el­i­gi­ble, there is no cost to par­tic­i­pate.

Flynn said most of his pa­tients in the pi­lot are re­ceiv­ing ei­ther On­tario Works or provin­cial dis­abil­ity ben­e­fits.

“That’s the pop­u­la­tion I want to help,” he said, adding On­tario’s new “Pa­tients First” ap­proach is in­tended partly to re­move ob­sta­cles for care.

And in many cases, he said, peo­ple sim­ply don’t have the money for chi­ro­prac­tic care. Oth­ers are con­cerned about try­ing it or have been steered away from the prac­tice by other prac­ti­tion­ers, said Flynn.

But he said the dis­ci­plines such as those in the pro­gram are vi­able al­ter­na­tives to pain med­i­ca­tion at a time when health pro­fes­sion­als are try­ing to re­duce the num­ber of ad­dic­tions and rate of over- pre­scrib­ing the pow­er­ful drugs.

Those who are ad­dicted are of­ten mis­un­der­stood, Flynn said.

“A lot of peo­ple feel it’s just drug­gies, just peo­ple try­ing to get high. That is not the case.”

The chi­ro­prac­tor said some peo­ple seek med­i­ca­tion for pain, then more pow­er­ful med­i­ca­tion if the less po­tent forms aren’t enough. They may be­come ad­dicted or con­tinue to do things which ag­gra­vate the cause of the pain, he added.

The pi­lot ended March 31, 2017 but was re­newed for an­other year.

Flynn said he’s now hop­ing to both ex­tend its du­ra­tion and ex­pand its reach.

“I think there should be some­thing like this in a lot of dif­fer­ent clin­ics, again with a fi­nan­cial cap.”

He said the deputy health min­is­ter re­quested more in­for­ma­tion the pro­ject and it has been no­ticed by oth­ers.

“This gov­ern­ment- funded pi­lot is uniquely po­si­tioned to sup­port pa­tients with chronic low back pain, the lead­ing cause of dis­abil­ity in North Amer­ica,” Dr. Bob Haig, the On­tario Chi­ro­prac­tic As­so­ci­a­tion’s chief ex­ec­u­tive of­fi­cer, said in a state­ment.

LUKE HENDRY/ THE INTELLIGENCER

Chi­ro­prac­tor Dr. Bruce Flynn holds a model of the lower back and pelvis Tues­day at the Belleville Nurse Prac­ti­tioner- Led Clinic. He and clinic staff are part of a provin­cially- funded pro­ject to re­duce lower back pain and pa­tients' use of painkillers. It won an award re­cently from the As­so­ci­a­tion of Fam­ily Health Teams of On­tario.

LUKE HENDRY/ THE INTELLIGENCER

Dr. Bruce Flynn treats pa­tient Va­lerie Ni­chol­son Tues­day at the Belleville Nurse Prac­ti­tioner- Led Clinic. He said chi­ro­prac­tic care and other dis­ci­plines are use­ful al­ter­na­tives to pain med­i­ca­tion for some pa­tients.

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