Osteopathic manipulative treatment of somatic dysfunction among patients in the family practice clinic setting: a retrospective analysis.
BACKGROUND
Relatively little has been published about contemporary use of osteopathic manipulative treatment (OMT) in family practice.


OBJECTIVE
To provide an "epidemiology" of somatic dysfunction, assessing prevalence and severity of somatic dysfunction encountered in the family practice setting, also characterizing physician use of OMT.


METHODS
Retrospective analysis of Outpatient Osteopathic SOAP Note Form data collected in 1998 and 1999 by 20 osteopathic medical trainee-investigators under the supervision of seven site-based osteopathic physicians.


METHODS
Three university-based, osteopathic family practice clinics.


RESULTS
The authors analyzed records for 1331 patient encounters and 424 adult patients. The mean (SD) age of patients was 56.9 years (16.2 years), and 71% were women. The median number of days between repeat encounters was 29 days. Somatic dysfunction was diagnosed in 418 (31%) patient encounters, affecting a total of 1199 anatomic regions (2.9+/-1.2 anatomic regions per patient). Investigators used OMT in 335 (25%) patient encounters to treat a total of 952 anatomic regions (2.8+/-1.2 anatomic regions per patient). For women, the odds ratio for receiving OMT was 1.4 (95% confidence interval [CI], 1.0-2.2); for patients using analgesics, anti-inflammatory agents, or muscle relaxants, the odds ratio was 2.2 (95% CI, 1.2-4.1). Immediately after OMT, investigators reported that patients' somatic dysfunction resolved or improved in a total of 747 (96%) anatomic regions and remained unchanged in 32 (4%) anatomic regions (P<.001). The authors used cluster analysis to classify anatomic regions by prevalence and severity of somatic dysfunction.


CONCLUSIONS
Somatic dysfunction was diagnosed in almost one-third of patient encounters. In one-quarter of patient encounters, investigators used OMT.
Licciardone
John C
JC
University of North Texas Health Science Center at Fort Worth-Texas College of Osteopathic Medicine, Fort Worth, TX 76107-2644, USA. jlicciar@hsc.unt.edu
Nelson
Kenneth E
KE
Glonek
Thomas
T
Sleszynski
Sandra L
SL
des Anges Cruser
D005194:Family Practice; D005260:Female; D006801:Humans; D008297:Male; D026301:Manipulation, Osteopathic; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000628:therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome