• Beliveau PJH
• Wong JJ
• Sutton DA
• Simon NB
• Bussières AE
• Mior SA
• French SD

• Affiliation / Canadian Memorial Chiropractic College (CMCC)
• Affiliation / Centre de recherche interdisciplinaire en réadaptation (CRIR)
• Affiliation / Centre for Disability Prevention and Rehabilitation (CDPR), Ontario Tech University and Canadian Memorial Chiropractic College (CMCC)
• Affiliation / Macquarie University. Faculty of Science and Engineering. Department of Chiropractic
• Affiliation / McGill University. Faculty of Medicine. School of Physical and Occupational Therapy
• Affiliation / Ontario Tech University. Faculty of Health Sciences
• Affiliation / Queen's University. Department of Public Health Sciences
• Affiliation / Université du Québec à Trois-Rivières (UQTR). Département de chiropratique
• Affiliation(G) / Canada / Ontario / Kingston
• Affiliation(G) / Canada / Ontario / Oshawa
• Affiliation(G) / Canada / Ontario / Toronto
• Affiliation(G) / Canada / Quebec / Montreal
• Affiliation(G) / Canada / Quebec / Trois-Rivières
• Chiropractic / statistics and numerical data
• Demography
• Open Access Document
• Patient Outcome Assessment
• Patients / statistics and numerical data
• Review Literature as Topic
• Therapeutics
• Utilization Review

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.

Author keywords: Chiropractic – utilization – patient demographics – assessment – treatment – statistics – scoping review

Author affiliations: PJHB, SDF: Department of Public Health Sciences, Queen's University, Kingston, Canada; JJW, DAS, SAM: UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT);  JJW: Canadian Memorial Chiropractic College (CMCC), Toronto, Canada; NBS, SAM: Department of Research, Canadian Memorial Chiropractic College, Toronto, ON; AEB: School of Physical and Occupational Therapy, McGill University, Montréal, Canada; AEB: Département chiropratique, Université du Québec à Trois-Rivières, Trois-Rivières, Canada; AEB: Centre de recherche interdisciplinaire en réadaptation (CRIR), Montréal, Canada; SDF: School of Rehabilitation Therapy, Queen's University, Kingston, Canada; SDF: Department of Chiropractic, Macquarie University, Sydney, Australia 

This abstract is reproduced with the permission of the publisher; click on the above link for free fill text. PubMed Record