Osteopathic manipulative treatment of somatic dysfunction among patients in the family practice clinic setting: A retrospective analysis

Context: 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. Design: 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. Setting: 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. Conclusion: Somatic dysfunction was diagnosed in almost one-third of patient encounters. In one-quarter of patient encounters, investigators used OMT.