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

Chiropractic & Manual Therapies

Peter C. Emary¹  Noori Akhtar-Danesh²  Mark Oremus³  Martin Wangler⁴  Taco A. W. Houweling⁵ 

[1] Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada;Chiropractic Department, D’Youville College, Buffalo, NY, USA;Private Practice, 1145 Concession Road, Cambridge, N3H 4L5, Ontario, Canada;Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada;School of Nursing, McMaster University, Hamilton, ON, Canada;Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada;School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada;Private Practice, Bern, Switzerland;Private Practice, Faubourg de l’Hôpital, Neuchâtel, Switzerland;

关键词: Chiropractic;    Attitudes;    Beliefs;    Drug prescription;    Switzerland;    Q-methodology;   

DOI  :  10.1186/s12998-020-00341-6

来源: Springer

【 摘 要 】

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.

【 授权许可】

CC BY