Objectives There is no current detailed profile of people seeking chiropractic care in Canada. We describe the profiles of chiropractors’ practice and the reasons, nature of the care provided to their patients and extent of interprofessional collaborations in Ontario, Canada.
Design Cross-sectional observational study.
Setting Primary care setting in Ontario, Canada.
Participants We randomly recruited chiropractors from a list of registered chiropractors (n=3978) in active practice in 2015. Of the 135 randomly selected chiropractors, 120 were eligible, 43 participated and 42 completed the study.
Outcome measures Each chiropractor recorded information for up to 100 consecutive patient encounters, documenting patient health profiles, reasons for encounter, diagnoses and care provided. Descriptive statistics summarised chiropractor, patient and encounter characteristics, with analyses accounting for clustering and design effects.
Results Chiropractors provided data on 3523 chiropractor-patient encounters. More than 65% of participating chiropractors were male, mean age 44 years and had practised on average 15 years. The typical patient was female (59% of encounters), between 45 and 64 years (43%) and retired (21%) or employed in business and administration (13%). Most (39.4%) referrals were from other patients, with 6.8% from physicians. Approximately 68% of patients paid out of pocket or claimed extended health insurance for care. Most common diagnoses were back (49%, 95% CI 44 to 56) and neck (15%, 95% CI 13 to 18) problems, with few encounters related to maintenance/preventive care (0.86%, 95% CI 0.2 to 3.9) and non-musculoskeletal problems (1.3%, 95% CI 0.7 to 2.3). The most common treatments included spinal manipulation (72%), soft tissue therapy (70%) and mobilisation (35%).
Conclusions This is the most comprehensive profile to date of chiropractic practice in Canada. People who present to Ontario chiropractors are mostly adults with a musculoskeletal condition. Our results can be used by stakeholders to make informed decisions about workforce development, education and healthcare policy related to chiropractic care.
- cross-sectional studies
- healthcare surveys
- professional practice
- musculoskeletal conditions
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Contributors Concept development (provided idea for the research): SM and SF. Design (planned the methods to generate the results): SM, SF and AB. Supervision (provided oversight, responsible for organisation and implementation, writing of the manuscript): SM, JW, DS, PJHB, AB and SF. Data collection/processing (responsible for experiments, patient management, organisation or reporting data): SM, JW, DS, PJHB, SH-J and SF. Analysis/interpretation (responsible for statistical analysis, evaluation and presentation of the results): SM, JW, DS, PJHB, AB, SH-J and SF. Literature search (performed the literature search): JW and DS. Writing (responsible for writing a substantive part of the manuscript): SM and DS. Critical review (revised manuscript for intellectual content, this does not relate to spelling and grammar checking): SM, JW, DS, PJHB, AB, SH-J and SF. Final approval and agreement for manuscript accountability: SM, JW, DS, PJHB, AB, SH-J and SF.
Funding This study was funded by the Ontario Chiropractic Association (OCA) and Queen’s University. The OCA provided general advice about the design of the project, but was not involved in the collection of data, data analysis, interpretation of data or drafting of the manuscript. The funder Queen’s University did not have any involvement in the project.
Competing interests SM has received an honorarium for lecturing from OCA.
Patient consent for publication Obtained.
Ethics approval The research ethics boards at the Canadian Memorial Chiropractic College (CMCC) (REB# 1404×03) and Queen’s University (REB# 6012853) approved the study.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement No data are available.
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