Primary Prevention in Chiropractic Practice: A Systematic Review
Guillaume Goncalves, Christine Le Scanff1, and
University of Paris-Sud,
University of Paris-Saclay
Background Chiropractors are primarily concerned with musculoskeletal disorders but have the responsibility to deal also with prevention in other areas.
Objectives To establish the prevalence of chiropractors who have a positive opinion on the use of primary prevention (PP), their actual use of PP, and the proportion of patients who consult for PP in relation to
(i) musculoskeletal disorders,
(ii) public health issues, or
(iii) chiropractic treatment for wellness.
Method A systematic search for literature was done using PubMed, Embase, Index to Chiropractic Literature, and and updated on February 15th 2017. Inclusion criteria were: surveys on chiropractors and/or chiropractic patients, information had to be present on PP in relation to the percentage of patients who consult for PP in chiropractic practice or in a chiropractic student clinic, and/or the percentage of chiropractors who reported using PP, and/or information on chiropractors’ opinions of the use of PP, in the English, French, or Scandinavian languages. The review followed the PRISMA guidelines. Articles were classified as ‘good’, ‘acceptable’ and ‘unacceptable’ based on scores of quality items. Results from the latter group were not taken into account.
Results Twenty-five articles were included, reporting on twenty-six studies, 19 of which dealt with wellness. The proportion of chiropractors who stated that they had a positive opinion on primary prevention (PP) was generally higher than the proportion of chiropractors offering PP. Most chiropractors offered some type of PP for musculoskeletal disorders and more than a half stated that they did so in the public health area but also for wellness. For all types of PP, however, it was rarely stated to be the reason for patients consulting. Regardless the type of PP, the proportion of patients who actually consulted specifically for PP was much smaller than the proportion of chiropractors offering PP.
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