Self-reported attitudes, skills and use of evidence-based practice among Swiss chiropractors: a national survey

Abstract

Study Objectives The high burden of disease associated with musculoskeletal disorders severely impacts patients’ well-being. As primary care providers, Swiss chiropractors ought to contribute towards identifying and using effective treatment strategies. An established approach is the full integration of evidence-based practice (EBP). This study aimed to investigate the attitudes, skills and use of EBP among Swiss chiropractors, as well as investigating potential facilitators and barriers for its adoption. Methods and material All 329 members of the Swiss Association of Chiropractic (ChiroSuisse) were invited in March 2021 to participate in this cross-sectional survey. Data were acquired anonymously online, using the Evidence-Based practice Attitude and utilization SurvEy (EBASE). The survey encompassed 55 questions measuring attitudes (n = 8, response range 1–5; total score range of 8–40), skills (n = 13, response range 1–5; total score range of range of 13–65) and use of EBP (n = 6, response range 0–4; total score range of 0–24). Results 228 (69.3%) chiropractors returned complete EBASE questionnaires. This sample was representative of all ChiroSuisse members with respect to gender, age groups and proportion of chiropractic residents. Respondents generally held positive attitudes towards EBP, as indicated by the high mean (31.2) and median (31) attitude sub-score (range 11–40). Self-reported skills had a mean sub-score of 40.2 and median of 40 (range 13–65). Knowledge about EBP-based clinical practice had been primarily obtained in chiropractic under- or postgraduate education (33.8% and 26.3%, respectively). Use of EBP achieved a lower sub-score, with mean and median values of 7.4 and 6, respectively (range 0–24). The most commonly identified barriers preventing EBP uptake were lack of time (67.9%) and lack of clinical evidence in chiropractic/manual therapy-related health fields (45.1%). Conclusion Swiss chiropractors held favourable attitudes and reported moderate to moderate-high skill levels in EBP. Nevertheless, similar to chiropractors in other countries, the self-reported use of EBP was relatively low, with lack of time and lack of clinical evidence being the most named barriers.

Feasibility of a new clinical journal club implementation and its association with knowledge, attitudes, and application of evidence-based practice among chiropractic students and trainees: a before-and-after healthcare education improvement study

“…In addition, our sample of chiropractic students also showed ceiling effects in 5 of 6 attitude subscale questions and 7 of 9 future use subscale questions which may demonstrate high affinity towards EBP constructs even prior to the journal club. However, a published article on self-reported attitudes, skills and use of evidence-based practice among Swiss chiropractors showed that 52% of respondents did not understand the full definition of EBP, which recognises that a patient’s preference also has to be taken into account for EBP [ 30 ]. Other national surveys of postgraduate chiropractors from the Canada, Sweden and the U.S., showed low to moderate subscores in EBP knowledge and use [ 31 – 33 ].…”

Feasibility of a new clinical journal club implementation and its association with knowledge, attitudes, and application of evidence-based practice among chiropractic students and trainees: a before-and-after healthcare education improvement study

“…In addition, our sample of chiropractic students also showed ceiling effects in 5 of 6 attitude subscale questions and 7 of 9 future use subscale questions which may demonstrate high a nity towards EBP constructs even prior to the journal club. However, a published article on self-reported attitudes, skills and use of evidence-based practice among Swiss chiropractors showed that 52% of respondents did not understand the full de nition of EBP, which recognises that a patient's preference also has to be taken into account for EBP [30]. Other national surveys of postgraduate chiropractors from the Canada, Sweden and the U.S., showed low to moderate subscores in EBP knowledge and use [31][32][33].…”

Personalized assessment and management of non‐specific low back pain

“…Studies with general practitioners and chiropractors show that among others, time constraints are the main barriers to following evidence‐based guidelines (e.g. ordering spine imaging is less time intensive than explaining why it is not needed) (Albisser et al., 2022; Pike et al., 2022). Second, even full adherence to guidelines would likely result in unsatisfactory treatment for many patients with NSLBP.…”