Dr. Patricia Tavares | Chiropractor, OCA Board Member,
OCA Research and Knowledge Translation Committee Chair

Dr. Tavares’ mission is to better serve underserved communities with chiropractic care.

Background highlights:

• Doctor of Chiropractic (DC) from CMCC in 1995
• Fellow of the College of Chiropractic Orthopaedic Specialists (Canada) or FCCOS(C) (specialty designation in orthopedics) in 2004
• Associate professor and primary clinician at CMCC since 2010
• Clinical director of World Spine Care
• Board member of World Spine Care Canada
• OCA Board member and chair of the OCA’s Research and Knowledge Translation Committee
• Executive Committee Member of the Canadian Chiropractic Guideline Initiative (CCGI)
• President of the College of Chiropractic Orthopaedic Specialists Canada
• Clinician, researcher and master’s student in the Clinical Management of Pain at the University of Edinburgh

How long have you been a chiropractor and what is your focus area?

I’ve been practising for the past 30 years. As soon as I graduated, I started a full-time practice in Bloor West Village in Toronto, focusing on acute and maintenance care, using techniques that included manipulation, acupuncture, rehab and patient education. However, I was forced to leave clinical practice in 2010 after four hand surgeries.

My areas of interest include women’s health and paediatrics, neurologic complications of diabetes, chronic pain and global health issues.

What inspired you to pursue research in chiropractic care?

I started being involved in research as an interventionist during my private practice. However, it’s teaching at CMCC that has led to a natural opportunity to be more involved in research projects.

In 2012, I joined CMCC interns on a 10-day outreach in the Dominican Republic (DR), providing chiropractic care to patients with Musculoskeletal (MSK) issues. There, I encountered patients with venous leg ulcers for the first time, and began investigating their prevalence in the region and their relation to ankle range of motion. I led an observational study with a multidisciplinary team and found that the prevalence of venous ulcers in the DR mirrors global rates and that with venous ulcers, ankle range of motion decreases significantly. A pilot study that preceded this work was an intra-examiner reliability study of an instrument that I would use to measure ankle range of motion.

The results of both studies were published in 2017 in the Journal of the Canadian Chiropractic Association (JCCA) and the Journal of Chiropractic Medicine.

What other research projects have you been involved in?

I’m currently involved as a co-investigator and co-author in the World Spine Care Canada (WSCC)’s project studying the implementation of the Global Spine Care Initiative (GSCI)’s spine care model in an Indigenous community in  Cross Lake, Manitoba. This involves triaging patients to the most effective and appropriate care, including chiropractic, with the aim to reduce opioid use for MSK issues like back and neck pain. My role is to train all volunteers on the model of care and how to use its classification systems. I also participated in a review of medical charts to see if the care provided using the GSCI model has made a change in the use of medications, including opioids, or imaging for spinal disorders. We expect results of this review soon.

I was also involved in a team led by Dr. Carol Ann Weis, chiropractor and associate professor at CMCC, looking at the Prevalence of Low Back Pain, Pelvic Girdle Pain, and Combination Pain in a Pregnant Ontario Population (2018) and in Prevalence of Low Back Pain, Pelvic Girdle Pain, and Combination Pain in a Postpartum Ontario Population (2020).

In addition, I was involved in two other recent projects: A study on Spinal Pain, Chronic Health Conditions and Health Behaviors: Data from the 2016–2018 National Health Interview Survey. The same team also conducted a secondary analysis of the association of cognitive impairment and spinal pain in the older adult population in the United States. This latter paper has now been accepted for publishing.

How does your research work contribute to the advancement of chiropractic care?

I hope that the work of the teams that I’ve been fortunate to be part of will contribute to the provision of evidence-based high value care in communities and populations who are currently underserved, and that reliance on medication and imaging for people in these communities decreases.

The OCA is also doing a tremendous amount of work in promoting the benefits of being involved in research and providing KT tools to help chiropractors translate research into practice, which I see in my role as an OCA board member and chair of the Research and KT Committee.

The committee is also proud to support the OCA’s Evidence-Based Chiropractic Care (EBCC) initiative, the goal of which is to advance the adoption of evidence-based care through the incorporation of research evidence, clinical expertise and patient preferences. A series of papers have been written, one of which will include a clinical decision tool for chiropractors.

What impact does your research have on improving patient outcomes?

Evidence shows chiropractic care plays a vital role in spinal health. Chiropractors as part of interdisciplinary health teams would be ideal for the patient. I hope my research can support greater integration of chiropractors into the broader health system.

How can students and chiropractors best stay informed about and integrate evidence-based research into their own practice?

At CMCC, students and interns are well trained in searching for evidence and asking the right questions. So, when you graduate and start practice in Ontario, I encourage you not to drop that ball. Keep going. Knowledge translation is the key to implementing research into practice. Stay tuned to the latest research through various means such as CMCC’s e-library (if you’re a CMCC member), OCA’s KT products, Dr. Shawn Thistle’s educational resources, Dr. Demetry Assimakopoulos and others who provide CE courses, and get involved in OCA’s committees.

It’s easy to stagnate in your ongoing learning in a busy practice, which happened to me at one point. Just be involved as much as possible and stay inquisitive in the quest for new knowledge!