Chiropractic Maintenance Care - what's new?
- RRS Education
- defining the idea of maintenance care and the indications for its use;
- describing chiropractors’ belief in maintenance care and patients’ acceptance of it;
- establishing the prevalence of maintenance care among chiropractors and potential characteristics of the chiropractors who use it; and
- determining the efficacy and cost-effectiveness of maintenance care for various conditions.
In the interest of evidence-based medicine, we have an obligation to scrutinize the methods that are utilized by chiropractors. If they are effective, we should promote them, if not, we should stop doing them. Sometimes the answer (to the question of effectiveness) may be less than crystal clear, as we are dealing with multifactorial conditions (such as pain) and very heterogeneous patient groups.
Maintenance Care is a management strategy that is commonly used by chiropractors world-wide. Still, a systematic review conducted in 2008 concluded that we knew very little about this way of treating patients: For whom is it recommended? For what conditions? What are the components of such a strategy and what is the frequency of care? How do chiropractors reason around this concept? Is it accepted by patients? Is it effective? Is it cost-effective?
We have now re-done the systematic review from 2008, and we found that the evidence-base of maintenance care has increased considerably. Through studies using many different methods (interviews, surveys, focus groups and randomized trials) we now have a clearer picture of what maintenance care is and how it is utilized. As is often the case, we cannot recommend this strategy for all, but there are some indications of effectiveness for a select group of patients.Iben Axén, DC, PhD. Unit of Intervention and Implementation Research for Worker Health, The Institute of Environmental Medicine (IMM) Karolinska Institutet, Stockholm, Sweden. Research leader of the Norwegian Chiropractic Foundation ELiB (Et Liv I Bevegelse = a life in movement).