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. 2017 Nov 22:25:35.
doi: 10.1186/s12998-017-0165-8. eCollection 2017.

The chiropractic profession: a scoping review of utilization rates, reasons for seeking care, patient profiles, and care provided

Peter J H Beliveau  1 , Jessica J Wong  2   3 , Deborah A Sutton  2 , Nir Ben Simon  3 , André E Bussières  4   5   6 , Silvano A Mior  2   3 , Simon D French  1   7   8
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The chiropractic profession: a scoping review of utilization rates, reasons for seeking care, patient profiles, and care provided

Peter J H Beliveau et al. Chiropr Man Therap. .

Abstract

Background: Previous research has investigated utilization rates, who sees chiropractors, for what reasons, and the type of care that chiropractors provide. However, these studies have not been comprehensively synthesized. We aimed to give a global overview by summarizing the current literature on the utilization of chiropractic services, reasons for seeking care, patient profiles, and assessment and treatment provided.

Methods: Systematic searches were conducted in MEDLINE, CINAHL, and Index to Chiropractic Literature using keywords and subject headings (MeSH or ChiroSH terms) from database inception to January 2016. Eligible studies: 1) were published in English or French; 2) were case series, descriptive, cross-sectional, or cohort studies; 3) described patients receiving chiropractic services; and 4) reported on the following theme(s): utilization rates of chiropractic services; reasons for attending chiropractic care; profiles of chiropractic patients; or, types of chiropractic services provided. Paired reviewers independently screened all citations and data were extracted from eligible studies. We provided descriptive numerical analysis, e.g. identifying the median rate and interquartile range (e.g., chiropractic utilization rate) stratified by study population or condition.

Results: The literature search retrieved 14,149 articles; 328 studies (reported in 337 articles) were relevant and reported on chiropractic utilization (245 studies), reason for attending chiropractic care (85 studies), patient demographics (130 studies), and assessment and treatment provided (34 studies). Globally, the median 12-month utilization of chiropractic services was 9.1% (interquartile range (IQR): 6.7%-13.1%) and remained stable between 1980 and 2015. Most patients consulting chiropractors were female (57.0%, IQR: 53.2%-60.0%) with a median age of 43.4 years (IQR: 39.6-48.0), and were employed (median: 77.3%, IQR: 70.3%-85.0%). The most common reported reasons for people attending chiropractic care were (median) low back pain (49.7%, IQR: 43.0%-60.2%), neck pain (22.5%, IQR: 16.3%-24.5%), and extremity problems (10.0%, IQR: 4.3%-22.0%). The most common treatment provided by chiropractors included (median) spinal manipulation (79.3%, IQR: 55.4%-91.3%), soft-tissue therapy (35.1%, IQR: 16.5%-52.0%), and formal patient education (31.3%, IQR: 22.6%-65.0%).

Conclusions: This comprehensive overview on the world-wide state of the chiropractic profession documented trends in the literature over the last four decades. The findings support the diverse nature of chiropractic practice, although common trends emerged.

Keywords: Chiropractic; assessment; patient demographics; scoping review; statistics; treatment; utilization.

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Conflict of interest statement

Ethics approval and consent to participate

Not applicable

Consent for publication

The authors of this publication have each given consent for publication.

Competing interests

PJHB, AEB, SAM and SDF have received research funding from the Canadian national and provincial chiropractic organizations, either as salary support or for research project funding. JJW received research project funding from the Ontario Chiropractic Association, outside the submitted work. SDF is Deputy Editor-in-Chief for Chiropractic and Manual Therapies; however, he did not have any involvement in the editorial process for this manuscript and was blinded from the editorial system for this paper from submission to decision.

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Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) flow diagram of the scoping review. aOther reasons to exclude articles included issues with article reliability, responsiveness, and interpretability within the context of how the four themes were presented in our review. bSome articles reported more than one topic
Fig. 2
Fig. 2
Studies by year of publication showing an increasing trend in the number of relevant publications. *using literature search of MEDLINE, CINAHL, and Index to Chiropractic Literature from database inception to January 14, 2016
Fig. 3
Fig. 3
12-month chiropractic utilization between 1980 and 2015
See this image and copyright information in PMC

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