Abstract
BackgroundSeveral published surveys have shown that chiropractors are generally split in their opinions regarding the right to prescribe drugs in chiropractic practice. Many of these studies have been limited by low response rates, leaving the generalizability of their findings open to question. The aim of the current study was to ascertain the general attitudes of chiropractors in Ontario, Canada toward the inclusion of drug prescription rights in their scope of practice. Relationships between these attitudes and the number of years in practice including differences in philosophical orientation were also explored.MethodsA 14-item questionnaire was developed and invitations sent via e-mail to all eligible 2,677 chiropractors in active practice registered electronically with the College of Chiropractors of Ontario in February 2015. Data were collected and analyzed using descriptive and inferential statistics.Results960 questionnaires were completed for a 36 % response rate. The majority of respondents agreed that chiropractors should be permitted to prescribe musculoskeletal medications such as over-the-counter and prescription-based analgesics, anti-inflammatories, and muscle relaxants. Over two-thirds also felt that with limited prescriptive authority chiropractors could help reduce patients’ reliance on these types of drugs. Over three-quarters were opposed however to chiropractors having full prescribing rights. The majority indicated they recommend over-the-counter medications to acute and chronic patients to some extent in clinical practice. Nearly two-thirds perceived their knowledge of musculoskeletal medications as high or very high, while a similar proportion perceived their knowledge of drugs for non-musculoskeletal conditions to be low or very low. A majority of respondents felt that further education in pharmacology would be necessary for those in the profession wishing to prescribe medications. More recent graduates and those who espoused a broad scope of chiropractic practice were most in favour of limited prescribing rights for the profession.ConclusionsA majority of responding Ontario chiropractors expressed interest in expanding their scopes of practice to include limited drug prescription. These results together with those of other recent surveys could indicate a shift in chiropractors’ attitudes toward drug prescription rights within the profession. Further surveys and/or qualitative studies of chiropractors in other jurisdictions are still needed.Electronic supplementary materialThe online version of this article (doi:10.1186/s12998-015-0066-7) contains supplementary material, which is available to authorized users.
Highlights
In some jurisdictions in the world chiropractors can gain licensure to prescribe medications from a limited formulary of over-the-counter (OTC) and/or prescription-based medications for common musculoskeletal conditions, such as non-steroidal anti-inflammatory drugs (NSAIDs), analgesics, and muscle relaxants [1, 2]
After removing duplicate and invalid e-mail addresses from the 2014–2015 Chiropractors of Ontario (CCO) directory, the questionnaire was sent to 2,847 chiropractors in Ontario, representing more than two-thirds (68.0 %) of all chiropractors in active practice registered with the CCO at the time of the survey (February 2, 2015 to February 27, 2015)
With respect to philosophical orientation, nearly one-third (31.7 %) of respondents classified themselves as practising within a ‘broad scope’ of chiropractic practice, over half (54.8 %) were ‘middle scope,’ and the remaining 13.4 % (128/952) of respondents identified themselves as ‘focused scope’ chiropractors
Summary
In some jurisdictions in the world chiropractors can gain licensure to prescribe medications from a limited formulary of over-the-counter (OTC) and/or prescription-based medications for common musculoskeletal conditions, such as non-steroidal anti-inflammatory drugs (NSAIDs), analgesics, and muscle relaxants [1, 2]. To date several published surveys [5,6,7,8,9] have shown that chiropractors are generally split in their opinions regarding the right to prescribe drugs in chiropractic practice. Several published surveys have shown that chiropractors are generally split in their opinions regarding the right to prescribe drugs in chiropractic practice. Many of these studies have been limited by low response rates, leaving the generalizability of their findings open to question. The aim of the current study was to ascertain the general attitudes of chiropractors in Ontario, Canada toward the inclusion of drug prescription rights in their scope of practice. Relationships between these attitudes and the number of years in practice including differences in philosophical orientation were explored
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