Chiropractic pediatric patient management and interdisciplinary collaboration: a descriptive cross-sectional study of chiropractors in Quebec

Abstract

Background Worldwide, many patients, including minors, seek chiropractic care. The purpose of this study was to investigate the practice characteristics of chiropractors who treat pediatric patients in Quebec, Canada. Methods We conducted a web-based cross-sectional survey of all licensed chiropractors working in Quebec (Canada). Data were collected using an adapted questionnaire. Descriptive statistics were produced for all the variables collected. Results Among our 245 participants (response rate: 21%), 63% were women, and half defined themselves as general musculoskeletal (MSK) health care practitioners. Nearly all participants reported seeing 0–5 new pediatric patients/week, and the most common pediatric age group was 6–12 years old (57%). Pediatric patients were most commonly referred by family members and “word of mouth”. The respondents most frequently indicated that they strongly agreed with statements affirming their confidence in their own diagnostic capacities regarding MSK disorders with respect to all age groups as well as non-MSK disorders with regard to young teens. They reported a moderate level of agreement with similar statements concerning the diagnosis of non-MSK disorders in newborns, preschoolers, and children. Chiropractors rarely referred their pediatric patients to a nurse/family doctor or a pediatrician. When presented with potential pediatric red flags, the respondents commonly indicated that they would refer the patient to a physician in an emergency situation or for comanagement. Conclusion Chiropractors in Quebec are confident in their diagnoses of pediatric MSK conditions and refer patients to physicians in the rare event of a worrisome presentation. However, some chiropractors may have expectations that are unsupported by evidence regarding the diagnosis and management of non-MSK complaints.

Chiropractic care and research priorities for the pediatric population: a cross-sectional survey of Quebec chiropractors

“…The analyzed sample included 245 respondents, for an effective response rate of 20.9%. Based on our comparison of the sample data with the available data for the complete membership of the OCQ, our sample presented a similar number of years of experience but included significantly more women (62.9% compared to 46.0%) [ 2 ].…”

“…As illustrated in a previous publication on this descriptive cross-sectional study, Quebec chiropractors commonly provide pediatric care but do not exclusively treat pediatric populations [ 2 ]. Our results reveal that chiropractors adapt their treatment techniques based on the patient’s age, using softer techniques on younger patients and slowly gravitating toward more commonly used techniques on adults when patients reach the age of six years.…”

“…Questions regarding the ranking of future research priorities, advice commonly given to pediatric patients and sources of information considered for pediatric care were added to the questionnaire by the investigators for the purpose of this study. The complete questionnaire is provided in a previous publication [ 2 ]. Briefly, a pilot study was carried out with a convenience sample of 29 chiropractors (May-June 2019) recruited on social media via posts on two Facebook pages targeting Quebec chiropractors with pediatric interests [ 8 ].…”

“…Although the prevalence of children younger than 18 seeking chiropractic care is lower than that in the adult population, globally, in the pediatric population, the estimated prevalence of use of chiropractic care over 12 months is 8.1% (IQR: 3.8–20.0), and the lifetime utilization rate is 11.1% (IQR: 4.0-21.6) [ 1 ]. Among pediatric patients in Quebec seeking care in chiropractic clinics, adolescents are the most common, followed by infants, school-age children and toddlers [ 2 ]. Musculoskeletal (MSK) conditions, excessive crying, neurological conditions and gastrointestinal conditions are stated as the main reasons for seeking chiropractic care in the pediatric population; however, other MSK or non-MSK conditions (ear, nose and throat conditions, infection, headache, asthma, stomach conditions, etc.)…”

Assessing adverse events associated with chiropractic care in preschool pediatric population: a feasibility study

“…Moreover, pediatric patients (i.e., under the age of 17 years) has been reported to constitute up to 38.7% of the patient population of chiropractors specializing in pediatrics [ 5 ]. Musculoskeletal complaints, such as back pain and neck pain, have been reported as the main reasons to receive manual therapies, but pediatric patients may present with a variety of conditions, such as attention deficit/hyperactivity disorder (ADHD), asthma, wellness/prevention, breastfeeding problems, neck torticollis, and plagiocephaly [ 6 , 7 ]. It is important to note that the management by the practitioner will not necessarily target the treatment of these conditions, but the neuromusculoskeletal symptoms that may be associated with them.…”