Older adults with low back pain often represent a complex clinical picture due to the inherent challenges of treating it, especially when combined with multiple co-morbidities. Given the potential for such complexity, it is important for clinicians and patients to consider these elements as management plans are designed and implemented. This article will focus on collaborative care for back pain and how it is practiced.
Multidisciplinary collaborative care including care coordination among providers is one possible approach to the management of complex back pain. Boon and colleagues defined collaborative care as "an interprofessional process for communication and decision making that enables the separate and shared knowledge and skills of health providers to synergistically influence patient care.
Successful collaboration requires patient interest and involvement, mutual respect, maintenance of professional autonomy, understanding each team members' practice scope, goal setting, and an openness to discussion and consensus-building processes.
Communication models that may support interprofessional collaboration include telephone consultations or face-to-face meetings, job shadowing experiences, the use of electronic medical records, and confirming understanding among team members.
This case presentation describes a collaborative effort between healthcare providers and a patient enrolled in a clinical trial on interdisciplinary co-management of older adults with LBP. The trial randomly allocated eligible participants to receive 12-weeks of LBP care under 1 of 3 professional practice models: medical care; concurrent medical and chiropractic care; or collaborative care involving the patient and a medical and chiropractic co-management team.
The co-management team collaborated through scheduled phone consultations and a secure, web-based, electronic communication system to share health records between the different health systems involved. The interprofessional practice model emphasized patient goal setting; provider discussions of diagnoses, complicating factors, and challenges to treatment; a cooperative treatment approach; monitoring patient status and care challenges; and ongoing support of the patient's treatment goals.