Skip to main content

Joseph DeFazio, DO

  • Graduate 2023
Current Position Information

Family Practice Physician, UPP Family Practice, Pittsburgh, Pennsylvania

Scholarly Research Project

Increasing Referrals for Osteopathic Manipulative Treatment (OMT) of Back Pain in Pregnancy at the Shadyside Family Health Center

Joseph DeFazio, DO; Rowena Pingul-Ravano, MD; Stephanie Ballard, PharmD, BCPS

Back pain during pregnancy is a significant issue that impacts patients’ quality of life by increasing pain and reducing functionality. OMT is an effective treatment for this disease state: It is safe, reduces pain, and improves functionality. OMT is already offered at the Shadyside Family Health Center but is an underutilized resource. We are hoping to increase the use of this resource at the Shadyside Family Health Center by simplifying the referral and scheduling process.

Involved the panel of pregnant patients receiving prenatal care at the Shadyside Family Health Center between March 2022 and March 2023 (n=29). It assessed the same data from a 2016-2017 pilot study (n=54) and used similar interventions while adding new interventions. Those interventions included patient education via ‘centering pregnancy’ meetings with pregnant patients and their partners that are already established as part of prenatal care at our office, as well as provider education during standing didactics lectures. It also updated communication with scheduling and offered additional appointment options for OMT follow-up at our office. Data was collected via manual chart review of the health center’s electronic medical record, then analyzed via descriptive statistics and run charts in a secure spreadsheet.

The above interventions resulted in an increase in referrals from 28 percent (2021, n=26) to 56 percent (2023, n=29). Completed visits for OMT were also targeted and these decreased from 40 percent to 33 percent.

This project aimed to improve treatment for and quality of life for our patients and explored office-based interventions that can be applied to other primary care clinics. It successfully improved referrals and highlighted barriers that could be addressed through sustainable interventions with subsequent iterations of this project.

Monroeville, Pennsylvania