J Patient Experience 2024 (Dec 25): 11:23743735241302992
Table 2.
Study Characteristics.
| Reference | Country | Aims | Participants | Setting of chiropractic care | Study design | Specific patient satisfaction/experience measures | Chiropractic intervention group | Control or comparison groups |
|---|---|---|---|---|---|---|---|---|
| Alcantara et al (2016) | United States | To explore the quality of life and satisfaction of care of patients receiving chiropractic care with the Webster Technique | n = 126 participants (low back pain, other pain, headaches, and wellness care), mean age = 39.68 (SD 12.56) [18-74]. 97 females, 29 males | Chiropractors participating in a PBRN —the International Chiropractic Paediatric Association who employ the Webster Technique. | Prospective cohort study—measures taken at baseline and following a course of chiropractic care | Patient satisfaction (RAND VSQ9) | Chiropractic care—Webster Technique, spinal adjustments, and adjunct therapies | |
| Alcantara et al (2018) | United States | To explore the quality of life and satisfaction of pregnant patients after receiving chiropractic care | n = 343 pregnant patients, mean age = 30.96 (4.64) | Chiropractors participating in a PBRN—the International Chiropractic Paediatric Association who employ the Webster Technique | Prospective cohort study—measures taken at baseline and following a course of chiropractic care | Patient satisfaction (RAND VSQ9) | Chiropractic care—Webster Technique, spinal adjustments, and adjunct therapies | |
| Amorin-Woods et al (2016) | Australia | To examine the outcomes of chiropractic manual and manipulative therapy compared to usual care for patients with nonspecific spinal pain within the context of a substance misuse rehabilitation | n = 71 patients with nonspecific spinal pain | Residential therapeutic community facility, with 14 weeks substance misuse rehabilitation (regular counseling and rehabilitative activities). A chiropractic community service was set up, delivered by supervised chiropractic interns | Clinical audit—evaluation of outcomes following a choice of care | Patient satisfaction (Patient Satisfaction Questionnaire—PSQ) | Usual care plus a package of chiropractic manual and manipulative therapy (manual and manipulative therapy received 6 treatments, once per week, over a 6-week period) | Usual care and simple analgesics (paracetamol, ibuprofen) |
| Bronfort et al (2011) | United States | To assess the relative efficacy of supervised exercise, spinal manipulation, and home exercise for the treatment of chronic low back pain | n = 301 chronic low back pain patients, mean age = 45.1 (11.0), F%= 60.5 | University-based clinic, with treatment provided by 9 experienced chiropractors | Randomized controlled trial—comparing spinal manipulative therapy, supervised exercise therapy, and home exercise and advice | Patient satisfaction was (7-point scale, with 1 representing “completely satisfied, couldn’t be better” and 7 “completely dissatisfied, couldn’t be worse”) | Spinal manipulative therapy, delivered by chiropractors who determined the frequency and number of treatments. Included short-lever, low-amplitude, high-velocity spinal manipulative therapy and adjunct therapies | • Supervized exercise therapy—20, 1 h sessions, performing core strengthening exercises and abdominal exercises emphasizing high number of repetitions and progressive increase in muscle load |
| Bronfort et al (2012) | United States | To assess the relative efficacy of spinal manipulative therapy and medication and home exercise for the treatment of acute and subacute neck pain | n = 272 participants with acute and subacute neck pain. SMT group: n = 91, mean age 48.3 (15.2), female: 58.2%. HEA group: n = 91, mean age 48.6 (12.5), females 65.9%. MED group: n = 90, mean age: 46.8 (12.2), females: 72.2% | University affiliated clinics, licensed chiropractors with 5 years minimum clinical experience | Randomized controlled trial—comparing spinal manipulation, medication, and home exercise | Patient satisfaction (multidimensional satisfaction instrument, scored on a 1-5 scale: poor, fair, good, very good, excellent). Includes 2 subscales, information and general care, which are scored by summing and transforming results to 0-100 scales (0 = worst, 100 = best). Global satisfaction (1-7 scale, from 1 = “completely satisfied, couldn't be better” to 7 = “completely dissatisfied, couldn't be worse”) | Spinal manipulative therapy, consisting of high velocity, low amplitude joint manipulation (diversified technique). Other therapies included light soft tissue massage, assisted stretching, heat or cold packs. Number of visits was determined by treating chiropractor | • Medication—provided by licensed physician at a pain management clinic and consistent of nonsteroidal anti-inflammatory drugs. The number of visits and choice of medication was at physicians’ discretion. • Home exercise and advice—2, 1 h appoints with advice and instruction on self-care measures, ergonomic recommendations, simple stretching and strengthening exercises |
| Bronfort et al (2014) | United States | To compare spinal manipulative therapy plus home exercise and advise to home exercise and advice alone in reducing leg pain in patients with subacute and chronic back related leg pain | n = 192 patients with back related leg pain. Spinal manipulative therapy plus home exercise group: n = 96, mean age = 57.1 (12.0), females 59%. Home exercise group: n = 96, mean age = 57.5 (11.9), females = 68% | Institution-affiliated research clinics based at two universities | Pragmatic controlled trial—comparing spinal manipulative therapy and home exercise and advice | Patient satisfaction (7-point scale, from 1 = poor to 7 = excellent) | Up to 30 visits for spinal manipulation therapy, including high velocity, low amplitude thrust procedures or low velocity, variable amplitude mobilization maneuvres. Frequency of visits, treatment, and adjunct therapies were decided by the chiropractor. Patients also attended four home exercise and advice visits | Home exercise and advice was delivered one-to-one in four 1h visits, over 12 weeks. This included instruction and practice of positioning and stabilization exercises. These were individualized to patients. Patients were instructed to do 8-12 repetitions of each exercise every other day |
| Brown et al (2014) | Australia | To describe patient characteristics and summarize their perceptions of chiropractic in Australia | n = 486 patients, females 324 (67.1%), males 159 (32.9%) | 96 chiropractic clinics across Australia | Cross-sectional survey | Perceptions of current chiropractic care (Work Force Study Survey Questionnaire) | ||
| Butler and Johnson (2008) | United States | To examine healthcare satisfaction by provider type and its effect on return to work | n = 1831 workers who filed workers’ compensation claims for occupational back pain | Chiropractors across the United States | Prospective cohort study—measured at baseline, 6 months, and 12 months after filing a claim for occupational back pain | Patient satisfaction (quality of care, good diagnosis, thorough treatment, effective treatment, took pain seriously, listening, respect, explanations of injury, and treatment). Overall satisfaction (5-point scale—1 very satisfied to 5 very dissatisfied). Individual healthcare satisfaction with the different physicians (4-point scale—1 agree strongly to 4 disagree strongly | ||
| Crowther (2014) | Canada | To explore the similarities and differences in satisfaction and dissatisfaction experiences of patients attending primary care physicians and chiropractors | n = 197 patients, mean age—55.0 (16.1), 122 females (62%), 75 males (38%) | Full-time chiropractors who had greater than 5 year experience | Qualitative study—semistructured interviews | Semistructured interviews based on Critical Incident Technique (discussing satisfying/dissatisfying experiences in chiropractic care and medical care) | ||
| Damaske et al (2016) | Belgium, Denmark, Finland, France, Greece, Hungary, Ireland, Italy, Norway, Portugal, Spain, Sweden, and the United Kingdom |
To examine chiropractic patients’ beliefs, experiences, and satisfaction with chiropractic care in an open environment | n = 1109 patients, 650 females, 458 males, 1 not indicated. Mean age = 46.5 (SD 15.4) | Registered chiropractors across Europe utilising an open environment | Cross-sectional survey | Patient satisfaction (11-point numerical rating scale: 0 = poor, 10 = exceptional) | ||
| Eriksen et al (2011) | United States, Canada, Europe | To describe both symptomatic reactions and clinical outcomes following a short term of chiropractic care | n = 1090 patients (multiple complaints, 80.9% spinal pain/dysfunction or headaches). Mean age = 46.1 (14.2). 699 females (64.1%), male 391 (35.9%) | 83 chiropractors in private practice | Prospective cohort study—following patients after upper cervical technique in chiropractic care | Patient satisfaction (11-point numerical rating scale: “How satisfied are you with the treatment by your chiropractor?” ranging from 0 = very dissatisfied to 10 = very satisfied) | Upper cervical technique—patient management and visit frequency were left to the discretion of the chiropractor, but asked to refrain from using any other type of spinal manipulation or physical therapy | |
| Field and Newell (2016) | United Kingdom | The examine and compare the outcomes of NHS and private patient groups presenting with musculoskeletal conditions to chiropractors | n = 8222 NHS referred and private patients (low back and neck pain) Mean age (NHS, 49.1; private 49.2) Female, 60.2% and 48.3% NHS and private, respectively) |
Consortium of UK-based practices located in the south of the United Kingdom | Prospective cohort of patients receiving a course of chiropractic care | Patient satisfaction (7 item scale: “Overall, how have you found the service and care your received?” ranging from
1 = unacceptably poor to 7 = a very high level, I) would recommend friends with similar problems to consider |
||
| Foley et al (2020) | Australia | To examine the extent to which patients with chronic conditions experience person-centered care when consulting complementary medicine practitioners | n = 153 participants with chronic conditions, 82.4% female, 17.0% male, 0.7% transgender. Chiropractic sample: n = 28 participants, 67.9% female, 32.1% male | Chiropractors participating in a PBRN | Cross-sectional survey | Experience of care and patient-practitioner communication (Patient-Centred Care Scale—PCCS, Perceived Provider Support Scale—PPSS, and the Patient Assessment of Chronic Illness Care Scale—PACIC) | ||
| Gaumer and Gemmen (2006) | United States | To determine the differences in attitudes and other determinants of care-seeking behavior between persons who have used chiropractic services and persons who have not | n = 800. Never visited a chiropractor: n = 400, 56.5% female, 43.5% male. Have visited a chiropractor: n = 400, 65.0% female, 35.0% male | - | Cross-sectional survey—national survey | Satisfaction with care (national survey) | ||
| Goertz et al (2013) | United States | To assess whether chiropractic manipulative therapy and standard medical care reduces pain and increases physical functioning compared to standard medical care only for the treatment of acute low back pain | n = 91 active-duty military personnel with acute low back pain. Standard medical care n = 46, 39 males (84.8%). Standard Med Care + Chiropractic n = 45, 39 males (86.7%) | Military medical centre | Pragmatic randomized comparative study—comparing chiropractic manipulative therapy and standard medical care to standard medical care | Patient satisfaction (11-point numerical rating scale, “How satisfied are you with the overall results of your care?” 0—not at all satisfied, 10—extremely satisfied) | Chiropractic manipulative therapy and standard medical care—focused history and physical examination and diagnostic imaging as indicated. High-velocity low amplitude manipulation, and ancillary treatments at the chiropractors discretion, including massage, exercises, advice on daily living, postural advice, and mobilization | Standard medical care—including any or all: history, physical examination, diagnostic imaging, self-management education, pharmacological management (analgesics and anti-inflammatories), physical therapy, referrals |
| Goertz et al (2018) | United States | To determine the effect of adding chiropractic care to usual medical care for patients with low back pain | n = 750 active-duty military participants with low back pain, 23.3% female, 76.7% male. Mean age = 30.9 *8.7) | Two military medical centers and one military training site | Pragmatic comparative trial—comparing usual medical care with chiropractic care to usual medical care | Patient satisfaction (11-point numerical rating scale: 0 = not at all satisfied, 10 = extremely satisfied) | Usual medical care with chiropractic care—participants had usual medical care, and up to 12 chiropractic care visits. This included spinal manipulative therapy for the low back. Treatment decisions on manipulation were based on patient diagnosis, patient preference, prior care, and medical/case history. Additional therapeutic procedures includes rehabilitative exercises, interferential current therapy, ultrasound, cryotherapy, superficial heat, and other manual therapies | Usual medical care—this was any care recommended or prescribed by military clinicians. This included: self-management advice, pharmacological pain management, physical therapy, or referral to a pain clinic |
| Haas et al (2005) | United States | To identify relative provider costs, clinical outcomes, and patient satisfaction for the treatment of low back pain | N = 837 chronic low back pain (attending chiropractor: n = 527, mean age 42.2 (14.4), females 55.4%. Attending medical care: n = 310, mean age 52.6 (12.7), females 52.6%). N = 1943 acute low back pain patients (attending chiropractor: n = 1328, mean age = 42.1 (12.9), 47.7% females. Attending medical care: n = 615, mean age = 38.5 (12.1), females 46.7%) | Practices of 51 chiropractic clinics | Prospective cohort study—comparing chiropractic care to medical care | Patient satisfaction (100-point scale) | Chiropractic care—spinal manipulation, physical modalities, exercise plan, and self-care education | Medical care—prescription drugs, exercise plan, self-care advice |
| Haas, Aickin, and Vavrek (2010) | United States | To present a model to identify the effects of expectancy of treatment success and patient-provider encounter on outcomes in an open-label randomized trial in treatment of cervicogenic headache | n = 80 participants with cervicogenic headache, mean age = 36 (SD, 11) 64 (80%) female, 18 (20%) male | Private chiropractic clinics | Preliminary path analysis from a randomized controlled trial which compared spinal manipulative therapy to minimal light massage | Measures of patient-provider encounters including patients’ perception of chiropractors enthusiasm for care, comfort treating cervicogenic headaches, confidence in care success, and adequate time (Likert scale) | Spinal manipulative therapy (high velocity, low amplitude spinal manipulation of the cervical and upper thoracic spine) delivered by a chiropractor | Minimal light massage (gentle effleurage and gentle petrissage of the neck and shoulder muscles) delivered by a chiropractor |
| Haas et al (2018) | United States | To determine the effect of spinal manipulative therapy on clinical outcomes in adults with chronic cervicogenic headache | n = 256 participants with cervicogenic headache, mean age = 41 (SD, 13). 182 (71.1%) female, 74 (28.9%) male | University affiliated clinics, either at a university of private clinics, by licensed chiropractors with 6-35 years of clinical experience | Randomized-controlled trial comparing spinal manipulative therapy to minimal light massage | Satisfaction with care (1-6 scale): 1—extremely dissatisfied, 2—dissatisfied, 3—somewhat dissatisfied, 4—somewhat satisfied, 5—satisfied, 6—extremely satisfied | Spinal manipulative therapy (high velocity, low amplitude spinal manipulation of the cervical and upper thoracic spine) delivered by a chiropractor. Groups included: 6 sessions of SMT and 12 sessions of light massage, 12 sessions of SMT and 6 sessions of light massage, and 18 sessions of SMT and 0 sessions of light massage | Minimal light massage (gentle effleurage and gentle petrissage of the neck and shoulder muscles) delivered by a chiropractor. Groups included: 0 sessions of SMT and 18 sessions of light massage |
| Haneline (2006) | United States | To determine whether patients with acute neck pain managed with chiropractic manipulative therapy benefited from chiropractic care and their satisfaction | n = 94 acute neck pain patients, mean age = 39.6 (15.7), 60 females (64%) and 34 males (36%) | Private chiropractic clinics | Cross-sectional survey | Patient satisfaction (6-point satisfaction scale—1 “very satisfied” to 6 “very dissatisfied,” questions on likelihood of choosing chiropractic care again, choosing which provider helped their condition the most) | ||
| Hays et al (2020) | United States | To evaluate the perceptions of chronic low back pain and neck pain patients receiving chiropractic care | n = 1835 patients with chronic low back pain or neck pain (mean age = 49), 74% female, 26% male | Private chiropractic clinics | Cohort study—baseline and 3 month follow up | Patient perceptions of care including communication and global rating of the provider (items from the CAHPS Clinician & Group Survey and additional items) | ||
| Hermansen and Miller (2008) | Norway | To gain an insight into everyday life and the struggles of an ADHD child having undergone chiropractic care as perceived by their mothers | n = 5 mothers, with in total 6 children with ADHD, age range 6-16 years, 3 females, 3 males | Single chiropractic clinic | Qualitative study—phenomenological study with semistructured interviews | Semistructured interviews | ||
| Houweling et al (2015) | Switzerland | To compare differences in pain levels, change in overall health, and patient satisfaction in those seeking care from medical doctors and doctors of chiropractic | n = 719 participants with spinal, hip, or shoulder pain. Medical care— n = 403, mean age = 45.7 (13.87), female 162 (40%), male 88 (22%). Chiropractic— n = 316, mean age = 41.3 (12.93), female 132 (42%), 74 (23%) | First-contact care patients who previously contacted the Swiss telemedicine provider regarding treatment advice, and who then consulted medical doctors or chiropractors regarding spinal, hip, or shoulder pain | Retrospective cohort study—baseline and 4 months | Patient satisfaction (5-point likert scale, ranging from very satisfied to very unsatisfied) | ||
| Lambers and Bolton (2016) | The Netherlands | To describe the quality of the perceived therapeutic alliance by patients and chiropractors | n = 207 chiropractic patients, 118 females (57.0%), 84 males (40.6%), 5 missing (2.4%) | Patients receiving care from chiropractors working in private practice in the Netherlands | Cross-sectional survey | Working alliance (Werkalliantievragenlijst—WAV-12 client version, rating each statement on 5-pont Likert scale ranging from “seldom to never” to “always” | ||
| Leininger, Evans, and Bronfort (2014) | United States | To assess satisfaction with care after receiving spinal manipulation therapy for acute and subacute neck pain | n = 272 participants with acute and subacute neck pain. SMT group: n = 91, mean age 48.3 (15.2), female: 58.2%. HEA group: n = 91, mean age 48.6 (12.5), females 65.9%. MED group: n = 90, mean age: 46.8 (12.2), females: 72.2% | University affiliated clinics, licensed chiropractors with 5 years minimum clinical experience | Secondary data analysis of data from a randomized controlled trial—comparing spinal manipulative therapy, medication, home exercise and advice | Patient satisfaction (multidimensional satisfaction instrument, scored on a 1-5 scale: poor, fair, good, very good, excellent). Includes 2 subscales, information and general care, which are scored by summing and transforming results to 0-100 scales (0 = worst, 100 = best). Global satisfaction (1-7 scale, from 1 = “completely satisfied, couldn't be better” to 7 = “completely dissatisfied, couldn't be worse”) | Spinal manipulative therapy, consisting of high velocity, low amplitude joint manipulation (diversified technique). Other therapies included light soft tissue massage, assisted stretching, heat or cold packs. Number of visits was determined by treating chiropractor | • Medication—provided by licensed physician at a pain management clinic and consistent of nonsteroidal anti-inflammatory drugs. The number of visits and choice of medication was at physicians’ discretion. • Home exercise and advice—participants attended 2, 1h visits focusing on self-mobilization exercises for the neck and shoulders over a 2-week period. Participants were instructed to perform 5-10 repetitions of the exercises 6-8 times a day at home |
| Mace et al (2012) | United Kingdom | To explore whether specific aspects of chiropractic treatment styles influence satisfaction rates | n = 186 patients, 70% females, 30% males | 3 chiropractic clinics | Cross-sectional survey (quantitative and qualitative) | Patient satisfaction (0-10 scale, and qualitative question—what they would change to improve satisfaction) | ||
| MacPherson et al (2015) | United Kingdom | To explore patients’ experiences and expectations of chiropractic care, perceptions of risks and benefits, and implications for chiropractors’ fitness to practise | n = 544 current and former patients, mean age = 54.5. Female = 360 (66%), male = 180 (33%), missing 4 (0.7%) | Current and former patients of registered chiropractors | Cross-sectional survey | Patient experience was measured with a questionnaire (developed from literature and prior qualitative work) | ||
| Maiers, Bronfort, et al (2014) | United States | To determine the relative short- and long-term effectiveness of spinal manipulative therapy with home exercise, supervised rehabilitative exercise and home exercise, and home exercise alone for older adults with chronic neck pain | n = 241 older adults with chronic neck pain. Spinal manipulative therapy and home exercise group: n = 80, mean age = 71.7 (5.2), 45.0% females. Supervised rehabilitative exercise and home exercise: n = 82, mean age = 72.6 (5.6), 51.2% females. Home exercise group: n = 79, mean age = 72.7 (5.3), 44.3% females | University chiropractic clinic, delivered by 11 licensed chiropractors with a minimum of 5 year experience | Randomized controlled trial—comparing spinal manipulative therapy, supervised exercise, and home exercise | Patient satisfaction (7-point scale from 1—completely satisfied, couldn’t be better to 7 completely dissatisfied, couldn’t be worse) | Spinal manipulative therapy, consisting of high velocity, low amplitude joint manipulation (diversified technique). Other therapies included light soft tissue massage, assisted stretching, heat or cold packs. Number of visits was determined by treating chiropractor | • Supervised exercise program—information and instruction for self-care of pain, light aerobic warm-up, instructions and monitoring of low load exercise with graded progression, and stretching, strength and balance exercises. Tailored to individual ability, delivered one-to-one by a therapist. 20 sessions. • Home exercise program—information and instructions for self-care of pain, stretching exercise, muscle strength and endurance exercises, balance exercises. Tailored to individual ability |
| Maiers, Vihstadt, et al (2014) | United States | To explore patients’ perceptions and satisfaction of spinal manipulative therapy and exercise | n = 222 older adults (65+) with chronic neck pain, mean age = 72.2 (5.4), female = 47% | University chiropractic clinic, delivered by 11 licensed chiropractors with a minimum of 5 year experience | Mixed-methods study embedded in a randomized controlled trial comparing spinal manipulative therapy, supervised exercise, and home exercise | Qualitative interview questions around satisfaction and worthwhileness of care | Spinal manipulative therapy, consisting of high velocity, low amplitude joint manipulation (diversified technique). Other therapies included light soft tissue massage, assisted stretching, heat or cold packs. Number of visits was determined by treating chiropractor | • Supervised exercise program—information and instruction for self-care of pain, light aerobic warm-up, instructions and monitoring of low load exercise with graded progression, and stretching, strength and balance exercises. Tailored to individual ability, delivered one-to-one by a therapist. 20 sessions. • Home exercise program—information and instructions for self-care of pain, stretching exercise, muscle strength and endurance exercises, balance exercises. Tailored to individual ability |
| Maiers et al (2016) | United States | To explore patients’ perceptions of and satisfaction with spinal manipulative therapy and home exercise with advice | n = 174 patients with chronic back-related leg pain, mean age = 57.0 (11.5), females 115 (66%), male 59 (34%) | Institution-affiliated research clinics based at 2 universities | Qualitative interviews following a randomized controlled trial comparing spinal manipulation therapy to home exercise and advice | Qualitative interview questions around satisfaction and worthwhileness of care | Up to 30 visits for spinal manipulation therapy, including high velocity, low amplitude thrust procedures or low velocity, variable amplitude mobilization maneuvres. Frequency of visits, treatment, and adjunct therapies were decided by the chiropractor. Patients also attended four home exercise and advice visits | Home exercise and advice was delivered one-to-one in four 1h visits, over 12 weeks. This included instruction and practice of positioning and stabilization exercises. These were individualized to patients. Patients were instructed to do 8-12 repetitions of each exercise every other day |
| Miller et al (2019) | United Kingdom | To investigate mothers’ reports of infant condition after chiropractic care, satisfaction, and side-effects | n = 2001 mothers, age of infants receiving care <12 weeks: n = 1583 (86%), > 12 weeks n = 256 (14%). 909 females (45%), males 1092 (55%) | Private chiropractors from 15 clinics, and within a teaching clinic | Cohort study—baseline and follow up (fourth visit or discharge visit) | Patient satisfaction (11-point scale) | ||
| Moore et al (2020) | Australia | To estimate the features of headaches in patients presenting to chiropractic care, and to explore associations with headaches type and patient satisfaction with headache management by a chiropractor | n = 203 patients with headache, 72.9% female, 27.1% male. Majority of participants were aged between 51-65 years | Chiropractors participating in a PBRN | Cross-sectional survey | Patient satisfaction—“please select which option best describes your level of satisfaction with chiropractic management of your headaches” | ||
| Myburgh et al (2016) | Denmark | To explore and describe healthcare encounters and perceived value in chiropractic practice | n = 12 patients for first consultation interview, 35 patients completed follow-up consultation interview, 11 patients had a first consultation videoed, 24 patients had a follow-up consultation videoed | Private practice | Mixed-methods study, interviews and observations | Patient experience (through qualitative interviews) | ||
| Navrud et al (2014) | United Kingdom | To explore parent satisfaction with pediatric chiropractic care | n = 395 infants, aged 1 day up to 36 weeks, 174 females (44.1%), 221 males (55.9%). Data reported by parents | Chiropractic teaching clinic | Cohort study—baseline and discharge | Patient satisfaction (10-point scale, from 1 “not at all” to 10 “completely satisfied” | ||
| Newell et al (2016) | United Kingdom | To explore the feasibility of collected health outcomes using a web-based PROM system within UK chiropractic practice | n = 1895 patients with low back or neck pain, mean age = 44.6 (13.0), 1010 females (53%), male = 885 males (47%) | Private practice | Cohort study—baseline and 90 days | Patient experience (rating their degree of patient-centredness in 5 domains: self-management, satisfaction with care, involved in decision making, explanation, and time, rating from “very good” to “very poor”) | ||
| Ryan et al (2018) | Australia | To compare the frequency and nature of complaints about chiropractors, osteopaths, and physiotherapists | n = 1139 complaints | − | Retrospective data analysis of national dataset (cross-sectional) | Patient dissatisfaction (complaints dataset). These are coded into domains (health, performance, conduct) and into 11 complaint issues (eg, treatment, communication, procedures) | ||
| Sadr et al (2012) | Canada | To explore the experience of chiropractic treatment for pregnant women with low back pain, and their chiropractors | n = 11 pregnant patients, age range 24-36 | Chiropractors actively seeing at least one pregnant patient | Qualitative study—semistructured interviews | Chiropractic treatment experience for their low back pain during pregnancy (semistructured interviews) | ||
| Schulz et al (2019) | United States | To determine the short- and long-term effectiveness of spinal manipulative therapy with home exercise, supervised rehabilitative exercise and home exercise, and home exercise alone for older adults with chronic low back pain | n = 241 older adults (65+) with chronic low back pain. Spinal manipulation therapy and home exercise group: n = 81, mean age 72.5 (5.6), females 46 (56.8%). Supervised rehabilitative exercise and home exercise group: n = 80, mean age = 73.6 (5.3), females 38 (47.5). Home exercise group: n = 80, mean age = 74.7 (5.6), females 40 (50.0%) | University chiropractic clinic, delivered by 11 licensed chiropractors with a minimum of 5 year experience | Randomized-controlled trial—comparing spinal manipulative therapy, supervised exercise therapy, and home exercise and advice | Patient satisfaction (7-point scale, from 1 = “completely satisfied, couldn't be better” to 7 = “completely dissatisfied, couldn't be worse”) | Spinal manipulative therapy and home exercise. Manual treatment based on condition, adjunct therapies to facilitate spinal manipulative therapies. Number of visits and technique used was determined by chiropractor | • Supervised exercise program—information and instruction for self-care of pain, light aerobic warm-up, instructions and monitoring of low load exercise with graded progression, and stretching, strength and balance exercises. Tailored to individual ability, delivered one-to-one by a therapist. 20 sessions. 60 min per sessions. Once a week. • Home exercise program—information and instructions for self-care of pain, stretching exercise, muscle strength and endurance exercises, balance exercises. Tailored to individual ability. Delivered one-to-one by a therapist. 4 sessions. 45-60 min per session. Once a week |
| Stomski et al (2019) | Australia | To establish the use of person-centered care delivered by chiropractic students | n = 108 adults with nonspecific spinal pain, 59.4% male, 40.6% female, mean age = 363. (SD 13.8) | Three chiropractic teaching clinics | Cohort study— pain intensity measures at baseline, and experience measures at fourth consultation | Person-centered care in consultations (Consultation and Relational Empathy questionnaire), process involved in medical consultations for musculoskeletal disorders (Picker Musculoskeletal Questionnaire) | ||
| Talmage et al (2009) | South Africa | To determine factors that may affect satisfaction levels of athletes receiving chiropractic care | n = 30 athletes, mean age = 35.6 (15.6), 63.3% male | Chiropractic care delivered by students in sport settings (surfing competition, bouldering competition, walk/run event) | Cross-sectional survey | Patient satisfaction (checklist of yes/no responses, including subscales of competence, humaneness, communication, and demeanor) | ||
| Walker, Hebert, Stomski, Losco, and French (2013) | Australia | To examine the comparative effectiveness of a brief chiropractic intervention compared with sham treatment for participants with spinal pain | n = 183 patients with spinal pain. Usual care group: n = 92, mean age 56.9 (14.6), 39 females 42.4%. Sham group: n = 91, mean age 53.0 (14.3), 28 females (30.8%) | Eight chiropractors | Randomized controlled trial—usual chiropractic care compared to sham group | Treatment satisfaction (5 response options ranging from very dissatisfied to very satisfied, dichotomized in analysis) | Usual chiropractic care—chiropractors administered individualized chiropractic care in line with their usual treatment approach (2 treatments with approximately 1 week between treatments) | Sham group—detuned ultrasound, low impulse thrust randomly administered on and around the spine using an activator on its lowest output and through a tongue depressor to disperse any remaining force, randomly placed hand on the spine |
| Weigel et al (2014) | United States | To compare function, health, and satisfaction between chiropractic care and medical treatments in Medicare beneficiaries | n = 12 170 Medicare beneficiaries with diagnosis of musculoskeletal disease, sprains or strains of joints and muscles. Aged over 65. 37% male | Private chiropractic care covered by Medicare | Cross-sectional survey—national survey from Medicare | Patient satisfaction (addressing quality of care received, doctor's concern for overall health, costs, access, follow-up care, information, from the Medical Current Beneficiary Survey) | ||
| Wells et al (2020) | United States | To explore older adults’ perceptions of healthcare during a clinical trial for low back pain (primary care, parallel primary care and chiropractic care, collaborative primary and chiropractic care) | n = 115 older adults with low back pain, 64% male, 36% female, mean age = 72.9 (6.2) | Licensed chiropractors at a chiropractic research centre | Qualitative interviews (secondary data analysis) | Structured interviews (following a randomized controlled trial) | Chiropractic treatment consisted of mobilization, instrument assisted manipulation, and/or spinal manipulative therapy focused on the low back complaint | |
Abbreviations:
ADHD = Attention Deficit Hyperactivity Disorder;
HEA = home exercise with advice;
MED = medication;
NHS = National Health Service;
PBRN = Practice-Based Research Network.