Evidence map›Paper›PMID 33076943›Full record

ArticleChiropractic & manual therapies2020

Attitudes, beliefs, and practices among Swiss chiropractors regarding medication prescribing for musculoskeletal conditions: a national Q-methodology study.

Peter C Emary, Mark Oremus, Taco A W Houweling, Martin Wangler, Noori Akhtar-Danesh

Open access · goldAbstract read
In one paragraph

Article in Chiropractic & manual therapies, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact, top 88% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 citations in OpenAlex.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 4 institutions in 3 countries.

Peter C EmaryDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada. emaryp@mcmaster.ca.ORCID 0000-0003-3044-8415
Mark OremusDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.
Taco A W HouwelingPrivate Practice, Faubourg de l'Hôpital, Neuchâtel, Switzerland.
Martin WanglerPrivate Practice, Bern, Switzerland.
Noori Akhtar-DaneshDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.
D'Youville College · USHôpital de la Providence · CHImpact · CAUniversity of Waterloo · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSwiss chiropractors have been licensed since 1995 to prescribe from a limited formulary of medications for treating musculoskeletal (MSK) conditions. In January 2018, this formulary was expanded to include additional muscle relaxant, analgesic, and anti-inflammatory medications. Internationally, controversy remains over whether or not medication prescribing should be pursued within the chiropractic profession.

objectiveThe purpose of this study was to assess Swiss chiropractors' attitudes, beliefs, and practices regarding their existing medication prescription privileges. This information will provide new insights on the topic and help inform research and policy discussions about expanding chiropractic prescription rights in other jurisdictions.

methodsA 13-item questionnaire and Q-methodology approach were used to conduct the assessment. Recruitment was conducted by e-mail between December 2019 and February 2020, and all members of the Swiss Chiropractic Association were eligible to participate. Data were analyzed using by-person factor analysis and descriptive statistics.

resultsIn total, 187 Swiss chiropractors participated in this study (65.4% response rate). Respondents reported prescribing analgesics, anti-inflammatories, and muscle relaxants to a median of 5, 5, and 0% of patients, respectively. Forty-two percent of respondents expressed interest in further expanding the range of current medications available to Swiss chiropractors for treating MSK conditions. Only 15% expressed interest in expanding this range to include medications for treating non-MSK conditions. In the Q-methodology analysis, four salient viewpoints/groups regarding medication prescribing emerged: prescribers, non-prescribers, collaborators, and integrators. All except non-prescribers thought medication prescription privileges were advantageous for the chiropractic profession in Switzerland. There was also strong consensus among all four groups that medication prescribing should not replace manual therapy in chiropractic practice.

conclusionThis was the first national survey on attitudes toward prescribing medications among Swiss chiropractors since the year 2000, and the first using Q-methodology. With this approach, four unique groups of chiropractic prescribers were identified. Even with diversity among clinicians, the findings of this study showed general support for, along with conservative use of, prescribing privileges within the Swiss chiropractic profession. Studies in jurisdictions outside of Switzerland are needed to assess whether chiropractors are interested in expanding their scopes of practice to include similar prescribing privileges.

Indexed as

Attitude of Health PersonnelAdultAnalgesicsAnti-Inflammatory AgentsChiropracticCross-Sectional StudiesDrug PrescriptionsFemaleHumansMaleMiddle AgedMusculoskeletal DiseasesNeuromuscular AgentsPhysiciansPractice Patterns, Physicians'Surveys and QuestionnairesAnalgesicsAnti-Inflammatory AgentsNeuromuscular AgentsAttitudesBeliefsChiropracticDrug prescriptionQ-methodologySwitzerland

Identifiers

PMID33076943
PMCPMC7574492
OpenAlexW3093169358

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.