Chiropractors and Pharmacists in a Family Health Team: Unlikely Allies in the Collaborative Management of Pregnancy-Related Low Back Pain
Bibliographic record
Abstract
C P J / R P C • M A R C H / A P R I L 2 0 1 1 • V O L 1 4 4 , N O 2 Introduction Although chiropractors often practise independently, there is evidence that a growing number are being integrated into multidisciplinary care environments. Co-management, openness to discussion and patient interest have been found to be key factors for developing a chiropractor’s involvement within a collaborative care setting. With the introduction of Bill 179 in Ontario, pharmacists will potentially be able to extend their scope of practice to improve their focus on clinical care activities. The Ontario Government is investing in collaborative care as a means of optimizing access to a wide range of health professionals to make best use of limited resources in the delivery of primary and specialty health care. In an effort to ensure that chiropractors in Ontario are practising to their full potential, a scope of practice review has been recommended by the chiropractic profession. This case report provides an example of the overlap of scopes of practice between pharmacists and chiropractors, emerging as a new common ally group in patient care. Both the pharmacist and chiropractor have been co-located within a family health team (FHT) environment for more than 5 years. Case history A 25-year-old female was referred by her family physician to a chiropractor for nonpharmacological treatment options regarding pregnancy-related low back pain (PLBP). The patient had a history of knee joint pain, flat feet, asthma, iron deficiency and gastroesophageal reflux disease. At the time of presentation, the medication regimen included: • Pulmicort Turbuhaler 200 mcg, one puff twice a day • Bricanyl Turbuhaler 0.5 mg, one puff every 6 hours, as needed • Ferrous fumarate 300 mg, one capsule daily • Diclectin 2 tablets at bedtime, 1 tablet in the morning and 1 tablet at noon • Acetaminophen 325 mg, 1–2 tablets every 6 hours for pain, as needed The patient was self-medicating with the acetaminophen 325 mg for PLBP, with minimal benefit. The patient presented with progressively worsening neck, middle and low back pain. These symptoms were limiting her ability to work. The chiropractor initiated care that included spinal manipulation, education on posture, muscle techniques and pacing strategies and pregnancyspecific exercises. Chiropractors and pharmacists in a family health team: Unlikely allies in the collaborative management of pregnancy-related low back pain
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.017 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.019 | 0.007 |
| Scholarly communication | 0.005 | 0.006 |
| Open science | 0.002 | 0.008 |
| Research integrity | 0.005 | 0.007 |
| Insufficient payload (model declined to judge) | 0.006 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".