{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T02:21:33Z","timestamp":1780712493603,"version":"3.54.1"},"reference-count":54,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,6,2]],"date-time":"2025-06-02T00:00:00Z","timestamp":1748822400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,6,2]],"date-time":"2025-06-02T00:00:00Z","timestamp":1748822400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"The Bravewell Collaborative"},{"DOI":"10.13039\/100008460","name":"National Center for Complementary and Integrative Health","doi-asserted-by":"publisher","award":["K23-AT010487"],"award-info":[{"award-number":["K23-AT010487"]}],"id":[{"id":"10.13039\/100008460","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Global Advances in Integrative Medicine and Health"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The integrative medicine (IM) clinic is an innovative care model that may increase access to guideline-concordant nonpharmacologic treatment use in healthcare delivery systems for prevalent conditions such as low back pain (LBP).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To describe the use and effectiveness of IM services for LBP in IM clinics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Research Design<\/jats:title>\n                    <jats:p>Prospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Subjects<\/jats:title>\n                    <jats:p>Adult patients with LBP enrolled at seventeen IM clinics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measures<\/jats:title>\n                    <jats:p>Patterns of IM service use were assessed over 12 months. Changes in clinical outcomes were assessed between index visit and 12-month follow-up using linear mixed-effects models. Primary (pain interference, physical function) and secondary (pain intensity, anxiety, depression, fatigue, sleep disturbance, social participation) outcomes were obtained from the PROMIS-29 instrument.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We identified 660 participants with LBP (mean age = 51.6 years, 75% female). Over the 12-month study period, common IM services were IM consults (56%), acupuncture (44%), chiropractic care (24%), physical therapy (19%), and massage (17%). Over two-thirds (70%) of participants received at least one guideline-concordant nonpharmacologic treatment. Participants with follow-up outcome data (n = 443, 67%) reported a modest reduction in pain interference with life activities in the short- and long-term (2-month mean difference [MD] = \u22121.47, 95%CI = \u22122.98, \u22120.64; 12-month MD = \u22121.98, 95%CI = \u22123.12, \u22120.88). By contrast, improvements in physical function were not statistically or clinically significant (2-month MD = 0.37, 95%CI = \u22120.28, 1.01; 12-month MD = 0.69, 95%CI = \u22120.31, 1.69). At 12 months, small improvements were observed on all secondary outcomes (pain intensity, anxiety, depression, and social participation) except fatigue and sleep disturbance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Most patients with LBP receiving care at IM clinics received at least one guideline-recommended nonpharmacologic treatment. However, improvements on clinical outcomes were relatively small. Additional multi-site studies are needed to explore the optimal implementation approach.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/27536130251345481","type":"journal-article","created":{"date-parts":[[2025,6,2]],"date-time":"2025-06-02T09:46:24Z","timestamp":1748857584000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Nonpharmacologic Back Pain Treatment Use and Associated Patient Reported Outcomes in US-Based Integrative Medicine Clinics"],"prefix":"10.1177","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3240-6756","authenticated-orcid":false,"given":"Eric J.","family":"Roseen","sequence":"first","affiliation":[{"name":"Boston University Chobanian & Avedision School of Medicine and Boston Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily E.","family":"Hurstak","sequence":"additional","affiliation":[{"name":"Boston University Chobanian & Avedision School of Medicine and Boston Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryung S.","family":"Kim","sequence":"additional","affiliation":[{"name":"Albert Einstein College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi","family":"Gao","sequence":"additional","affiliation":[{"name":"Albert Einstein College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3078-2918","authenticated-orcid":false,"given":"Carol M.","family":"Greco","sequence":"additional","affiliation":[{"name":"University of Pittsburgh School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David R.","family":"Vago","sequence":"additional","affiliation":[{"name":"Harvard Medical School"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert B.","family":"Saper","sequence":"additional","affiliation":[{"name":"Cleveland Clinic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6053-2602","authenticated-orcid":false,"given":"Benjamin","family":"Kligler","sequence":"additional","affiliation":[{"name":"VA Office of Patient Centered Care and Cultural Transformation"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. Diane","family":"McKee","sequence":"additional","affiliation":[{"name":"University of Massachusetts Chan Medical School"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9581-0564","authenticated-orcid":false,"given":"Jeffery A.","family":"Dusek","sequence":"additional","affiliation":[{"name":"University of California \u2013 Irvine"},{"name":"University of California \u2013 Irvine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"For the PRIMIER Study","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,6,2]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.0734"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2665-9913(23)00098-X"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.0158"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.7326\/M16-2367"},{"key":"e_1_3_5_6_2","volume-title":"WHO Guideline for Non-surgical Management of Chronic Primary Low Back Pain in Adults in Primary and Community Care Settings","year":"2023","unstructured":"WHO Guideline for Non-surgical Management of Chronic Primary Low Back Pain in Adults in Primary and Community Care Settings. 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