Implementation of neuroreflexotherapy for subacute and chronic neck and back pain within the Spanish public health system: audit results after one year.
Controlled randomized trials have demonstrated the efficacy, safety, effectiveness, and cost-effectiveness of neuroreflexotherapy (NRT) for the management of non-specific back pain. In this audit study, we describe the implementation of NRT into the routine practice of primary care within the Spanish public health service of the Balearic Islands and the results obtained after one year (2004). A referral protocol was made available to all general practitioners (GPs) who could refer eligible patients to specialized units in performing NRT interventions. A total of 1209 patients (median age 52 years, 68% women) were referred to NRT by 412 GPs (80% of all GPs), with a mean (standard deviation (S.D.)) referral rate of 1.57 (0.84) patients per month/10,000 persons affiliated to each practice, and an appropriate referral rate of 95.5%. Pain decreased from a median score (visual analog scale) of 8 at baseline to 1 at discharge, referred pain from 7 to 1, and disability (Roland-Morris Questionnaire) from 12 to 1. NRT was refused by 2.7% of patients. Adverse effects related to the procedure were only a skin reaction in 3.3% of patients. We conclude that it is feasible to implement NRT in the public health service complying with methods and application conditions used in previous randomized controlled trials (RCTs). In such conditions, implementation of this technology obtained positive audit results at one year.
Direcció General de Planificació i Finançament, Conselleria de Salut i Consum del Govern de les Illes Balears, Plaza de España 9, E-07003 Palma de Mallorca, Spain. ipujol@dgpif.caib.es
Josep
J
Corcoll
Jaume
J
Orfila
Pablo
P
Tobajas
Luis
L
Alegre
D000368:Aged; D001416:Back Pain / Q000628:therapy*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D009313:National Health Programs; D019547:Neck Pain / Q000628:therapy*; D011635:Public Health Administration; D012028:Reflexotherapy; D013030:Spain