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

Abstract Background Swiss 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. Objective The 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. Methods A 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. Results In 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. Conclusion This 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.

Download Full-text

Chiropractors' attitudes toward drug prescription rights: a narrative review

Chiropractic & Manual Therapies ◽

10.1186/s12998-014-0034-7 ◽

2014 ◽

Vol 22 (1) ◽

Cited By ~ 1

Author(s):

Peter Charles Emary ◽

Kent Jason Stuber

Keyword(s):

Drug Prescription ◽

Narrative Review ◽

Prescribe Medication ◽

Prescription Privileges ◽

Over The Counter ◽

Medication Prescription ◽

Independent Prescribing ◽

The United Kingdom ◽

Chiropractic Practice ◽

The Right

Abstract Background The right to prescribe drugs remains a contentious issue within the chiropractic profession. Nevertheless, drug prescription by manual therapy providers is currently an important topic. Notably, physiotherapists in the United Kingdom were recently granted limited independent prescribing rights. Reports suggest that physiotherapists in Australia now want those same rights, and as such a review of chiropractors' general attitudes toward drug prescription is needed. Objective To examine the literature concerning chiropractors' attitudes toward drug prescription rights and to compare the opinions of chiropractors currently licensed to prescribe medication with those in the profession who are not. Methods This was a narrative review, consisting of a formal literature search and summary of included articles. Electronic databases searched included the Cumulative Index to Nursing and Allied Health Literature, PubMed, and the Index to Chiropractic Literature. Inclusion criteria consisted of prospective studies published in English in peer-reviewed journals. Studies were required to contain data on chiropractors' opinions toward medication prescription rights. Results Of 33 articles identified, a total of seven surveys were included in the review. Of these, there was a general split in opinion among chiropractors regarding the right to prescribe drugs in chiropractic practice. Those supportive of prescribing rights favoured a limited number of over-the-counter and/or prescription-based medications such as analgesics, anti-inflammatories, and muscle relaxants. When questioned on full prescribing rights, however, chiropractors were generally opposed. In jurisdictions where chiropractors are currently licensed to prescribe from a limited formulary, such as in Switzerland, the majority perceived this right as an advantage for the profession. Moreover, continuing education in pharmacology was viewed as a necessary component of this privilege. Conclusions Based on the literature to date there is a general split in chiropractors' attitudes toward drug prescription rights. This split is most pronounced in countries where chiropractors are not licensed to prescribe medications. Notwithstanding, this is an important topic in chiropractic currently and warrants both further discussion and research to determine future directions and the implications of either pursuit or denial of prescription rights by chiropractors. Future surveys and/or qualitative studies of other chiropractors' opinions toward gaining prescription privileges would be timely.

Download Full-text

Looking back at the lawsuit that transformed the chiropractic profession part 8: Judgment impact

Journal of Chiropractic Education ◽

10.7899/jce-21-29 ◽

2021 ◽

Vol 35 (S1) ◽

pp. 117-131 ◽

Cited By ~ 7

Author(s):

Claire D. Johnson ◽

Bart N. Green

Keyword(s):

United States ◽

The United States ◽

Qualitative Inquiry ◽

Chiropractic Profession ◽

Final Decision ◽

Business Practices ◽

American Hospital ◽

American Hospital Association ◽

Chiropractic Practice ◽

Practice Education

Objective This paper is the eighth in a series that explores the historical events surrounding the Wilk v American Medical Association (AMA) lawsuit in which the plaintiffs argued that the AMA, the American Hospital Association, and other medical specialty societies violated antitrust law by restraining chiropractors' business practices. The purpose of this paper is to discuss the possible impact that the final decision in favor of the plaintiffs may have had on the chiropractic profession. Methods This historical research study used a phenomenological approach to qualitative inquiry into the conflict between regular medicine and chiropractic and the events before, during, and after a legal dispute at the time of modernization of the chiropractic profession. Our methods included obtaining primary and secondary data sources. The final narrative recount was developed into 8 papers following a successive timeline. This paper is the eighth of the series that discusses how the trial decision may have influenced the chiropractic that we know today in the United States. Results Chiropractic practice, education, and research have changed since before the lawsuit was filed. There are several areas in which we propose that the trial decision may have had an impact on the chiropractic profession. Conclusion The lawsuit removed the barriers that were implemented by organized medicine against the chiropractic profession. The quality of chiropractic practice, education, and research continues to improve and the profession continues to meet its most fundamental mission: to improve the lives of patients. Chiropractors practicing in the United States today are allowed to collaborate freely with other health professionals. Today, patients have the option to access chiropractic care because of the dedicated efforts of many people to reduce the previous barriers. It is up to the present-day members of the medical and chiropractic professions to look back and to remember what happened. By recalling the events surrounding the lawsuit, we may have a better understanding about our professions today. This information may help to facilitate interactions between medicine and chiropractic and to develop more respectful partnerships focused on creating a better future for the health of the public. The future of the chiropractic profession rests in the heads, hearts, and hands of its current members to do what is right.

Download Full-text

Alcohol Industry Involvement in the Moderate Alcohol and Cardiovascular Health Trial

American Journal of Public Health ◽

10.2105/ajph.2019.305508 ◽

2020 ◽

Vol 110 (4) ◽

pp. 485-488 ◽

Cited By ~ 1

Author(s):

Gemma Mitchell ◽

Matthew Lesch ◽

Jim McCambridge

Keyword(s):

Public Health ◽

Health Research ◽

Research Funding ◽

Cardiovascular Health ◽

Policy Decision ◽

Public Health Research ◽

National Institutes Of Health ◽

Alcohol Industry ◽

E Mail ◽

Research And Policy

The National Institutes of Health stopped the worldwide Moderate Alcohol and Cardiovascular Health (MACH) trial in 2018 because of institutional failings that led to the biased design of this major study. Drawing on e-mail correspondence among officials, researchers, and alcohol companies, we provide the first, to our knowledge, detailed analysis of alcohol industry involvement in the MACH trial. Alcohol companies agreed to fund the MACH trial to advance their commercial interests rather than to help answer a major scientific question. Alcohol industry executives seized opportunities presented by discussions of the MACH trial to try to influence this study and wider public health, research, and policy decision-making. The process of soliciting research funding from corporations, which included convincing alcohol companies that the study design supported their commercial interests, was intrinsically biased. Thus, the three parties—research funding officials, researchers, and industry executives—coproduced the biased trial design. A detailed understanding of this episode will be helpful in advancing efforts to protect public health research from biases associated with corporate donations.

Download Full-text

PENGALAMAN PEROKOK RENDAH TAR DAN NIKOTIN DI KOTA MALANG

Jurnal Keperawatan ◽

10.22219/jk.v1i1.395 ◽

2010 ◽

Vol 1 (1) ◽

Author(s):

Kumboyono . ◽

Junaiti Sahar ◽

Wiwin Wiarsih

Keyword(s):

Lower Risk ◽

Phenomenological Study ◽

Smoking Habit ◽

Maximal Rate ◽

Stop Smoking ◽

The Government ◽

Year 2000 ◽

E Mail ◽

Light Cigarettes

PENGALAMAN PEROKOK RENDAH TAR DAN NIKOTIN DI KOTA MALANGSmoker Experience In Low-Tar And Nicotine MalangKumboyono1, Junaiti Sahar2, Wiwin Wiarsih31Program Studi Ilmu Keperawatan Fakultas Kedokteran Universitas BrawijayaJl. Veteran Malang 651452, 3Fakultas Ilmu Keperawatan Universitas Indonesia1)e-mail: [email protected] atau [email protected])e-mail: [email protected] rokok rendah tar dan nikotin (mild) menimbulkan asumsi bahwa rokok jenis ini lebih ramah terhadap kesehatan. Hal ini dikaitkan dengan PP No. 38 tahun 2000 pasal 4 ayat 1, menyebutkan batasan kadar maksimal per batang rokok untuk tar adalah 20 mg dan nikotin 1,5 mg. Pembatasan ini dimaksudkan untuk menurunkan kandungan kadar tar dan nikotin yang lebih tinggi pada rokok kretek yang selama ini telah beredar di Indonesia. Penelitian ini bertujuan mendeskripsikan makna pengalaman perokok dalam mengkonsumsi rokok mild di Kota Malang. Penelitian dilakukan dengan desain fenomenologi pada tujuh partisipan. Penelitian menghasilkan empat tema yaitu: alasan merokok mild; perubahan yang terjadi setelah menjadi perokok mild; makna kebiasaan merokok; jenis dan strategi layanan yang dibutuhkan untuk berhenti merokok. Kesimpulan penelitian ini ialah perokok menilai rokok rendah tar dan nikotin merupakan rokok ringan sehingga memacunya untuk terus menerus merokok dengan hisapan yang lebih dalam atau lebih banyak. Pemerintah disarankan untuk melarang pencantuman label mild dan sejenisnya yang dapat dipersepsikan secara keliru oleh perokok.Kata kunci: berhenti merokok, fenomenologi, perokok, rokok mildABSTRACTThe mild cigarette led to the assumption that this cigarette has a lower risk for health. This matter is related to PP No. 38 year 2000 section 4 article 1, mentioning maximal rate constrain per bar smoke for tar is 20 nicotine and mg 1,5 mg. This demarcation is meant to degrade rate content of tar higher level nicotine and cigarette of kretek which during the time have circulated in Indonesia. This phenomenological study was aimed to describe the meanings of smoker’s experiences regarding the mild cigarettes consumption in Malang. Seven participants were selected. The results showed four themes: smoking reasons; changes that happen after smoking; meanings in relation with smoking habit; strategies needed to stop smoking. This study concluded that smokers believed the mild cigarettes were categorized in light cigarettes, and as a consequence, smokers have more interest in smoking continuously and inhaling more deeply. The government is suggested to stop putting the label of mild/other similar labels in a cigarettes pack which could be perceived incorrectly by smokers.Keywords: mild cigarettes, phenomenology, smokers, stop smoking

Download Full-text

Essential literature for the chiropractic profession: Results and implementation challenges from a survey of international chiropractic faculty

Journal of Chiropractic Education ◽

10.7899/jce-17-4 ◽

2017 ◽

Vol 31 (2) ◽

pp. 140-163

Author(s):

Barbara A. Mansholt ◽

Stacie A. Salsbury ◽

Lance G. Corber ◽

John S. Stites

Keyword(s):

Faculty Members ◽

Chiropractic Profession ◽

Original Research ◽

Publication Date ◽

Web Based ◽

Implementation Challenges ◽

Spine Pain ◽

Chiropractic Education ◽

Chiropractic Practice ◽

Collection Methods

Objective: Scientific literature applicable to chiropractic practice proliferates in quantity, quality, and source. Chiropractic is a worldwide profession and varies in scope between states or provinces and from country to country. It is logical to consider that the focus and emphasis of chiropractic education varies between programs as well. This original research study endeavored to determine “essential literature” recommended by chiropractic faculty. The purpose of this article is (1) to share our results and (2) to promote discussion and explore means for future collaboration of chiropractic faculty through a worldwide platform. Methods: A 2-phase recruitment occurred initially at the institutional level and subsequently at the faculty level. A Web-based survey used qualitative data collection methods to gather bibliographic citations. Descriptive statistics were calculated for demographics, and citation responses were ranked per number of recommendations, grouped into categories, and tabulated per journal source and publication date. Results: Forty-one chiropractic programs were contacted, resulting in 30 participating chiropractic programs (16 US and 14 international). Forty-five faculty members completed the entire survey, submitting 126 peer-reviewed publications and 25 additional citations. Readings emphasized clinical management of spine pain, the science of spinal manipulation, effectiveness of manual therapies, teaching of chiropractic techniques, outcomes assessments, and professional issues. Conclusion: A systematic approach to surveying educators in international chiropractic institutions was accomplished. The results of the survey provide a list of essential literature for the chiropractic profession. We recommend establishing a chiropractic faculty registry for improved communication and collaboration.

Download Full-text

A commentary on the implications of medication prescription rights for the chiropractic profession

Chiropractic & Manual Therapies ◽

10.1186/s12998-016-0114-y ◽

2016 ◽

Vol 24 (1) ◽

Cited By ~ 7

Author(s):

Peter C. Emary ◽

Taco A. W. Houweling ◽

Martin Wangler ◽

Stephen J. Burnie ◽

Katherine J. Hood ◽

...

Keyword(s):

Chiropractic Profession ◽

Medication Prescription

Download Full-text

A hitchhiker’s guide to microscopy and microanalysis using telecommunications, e-mail, and the Internet

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100169687 ◽

1994 ◽

Vol 52 ◽

pp. 390-391 ◽

Cited By ~ 1

Author(s):

Nestor J. Zaluzec

Keyword(s):

The Internet ◽

Information Superhighway ◽

The World ◽

Exchange Information ◽

On Line ◽

Computer Based ◽

Software And Hardware ◽

Communication Software ◽

Basic Ideas ◽

E Mail

The Information SuperHighway, Email, The Internet, FTP, BBS, Modems, : all buzz words which are becoming more and more routine in our daily life. Confusing terminology? Hopefully it won't be in a few minutes, all you need is to have a handle on a few basic concepts and terms and you will be on-line with the rest of the "telecommunication experts". These terms all refer to some type or aspect of tools associated with a range of computer-based communication software and hardware. They are in fact far less complex than the instruments we use on a day to day basis as microscopist's and microanalyst's. The key is for each of us to know what each is and how to make use of the wealth of information which they can make available to us for the asking. Basically all of these items relate to mechanisms and protocols by which we as scientists can easily exchange information rapidly and efficiently to colleagues in the office down the hall, or half-way around the world using computers and various communications media. The purpose of this tutorial/paper is to outline and demonstrate the basic ideas of some of the major information systems available to all of us today. For the sake of simplicity we will break this presentation down into two distinct (but as we shall see later connected) areas: telecommunications over conventional phone lines, and telecommunications by computer networks. Live tutorial/demonstrations of both procedures will be presented in the Computer Workshop/Software Exchange during the course of the meeting.

Download Full-text