Swiss chiropractic practice-based research network and musculoskeletal pain cohort pilot study: protocol of a nationwide resource to advance musculoskeletal health services research

Abstract

IntroductionMusculoskeletal (MSK) pain conditions, a leading cause of global disability, are usually first managed in primary care settings such as medical, physiotherapy, and chiropractic community-based practices. While chiropractors often treat MSK conditions, there is limited real-world evidence on the topic of health service outcomes among patients receiving this type of care. A nationwide Swiss chiropractic practice-based research network (PBRN) and MSK pain patient cohort study will have potential to monitor the epidemiological trends of MSK pain conditions and contribute to healthcare quality improvement. The primary aims of this protocol are to (1) describe the development of an MSK-focused PBRN within the Swiss chiropractic setting, and (2) describe the methodology of the first nested study to be conducted within the PBRN—an observational prospective patient cohort pilot study.Methods and analysisThis initiative is conceptualised with two distinct phases. Phase I focuses on the development of the Swiss chiropractic PBRN, and will use a cross-sectional design to collect information from chiropractic clinicians nationwide. Phase II will recruit consecutive patients aged 18 years or older with MSK pain from community-based chiropractic practices participating in the PBRN into a prospective chiropractic cohort pilot study. All data collection will occur through electronic surveys offered in the three Swiss official languages (German, French, Italian) and English. Surveys will be provided to patients prior to their initial consultation in clinics, 1 hour after initial consultation, and at 2, 6 and 12 weeks after initial consultation.Ethics and disseminationEthics approval has been obtained from the independent research ethics committee of Canton Zurich (BASEC-Nr: 2021-01479). Informed consent will be obtained electronically from all participants. Findings will be reported to stakeholders after each study phase, presented at local and international conferences, and disseminated through peer-reviewed publications.Study pre-registrationPhase I—Swiss chiropractic PBRN (ClinicalTrials.gov identifier: NCT05046249); Phase 2—Swiss chiropractic cohort (Swiss ChiCo) pilot study (ClinicalTrials.gov identifier: NCT05116020).

A retrospective analysis of the incidence of severe adverse events among recipients of chiropractic spinal manipulative therapy

“…A prospective multicenter registry of patients receiving chiropractic SMT would allow an estimate of the incidence and independent predictors of AEs while maximizing the available sample size. Examples of practice-based research networks, including chiropractic providers, include BraveNet in the United States 51 , the Australian Chiropractic Research Network 52 , and the Swiss chiropractic practice-based research network 53 . In addition, the current study could be updated in another three to four years which may allow sufficient sample size to identify independent predictors of severe AEs.…”

The Swiss chiropractic practice-based research network: a population-based cross-sectional study of chiropractic clinicians and primary care clinics to inform future musculoskeletal health care research

“…Further details of the study methods, including the patient and public involvement strategy are provided in the published study protocol. [22] Recruitment began at the annual ChiroSuisse Continuing Education (CE) Convention 2021 (Lausanne, September 9-11). At the convention, clinicians were provided the opportunity to sign up for the Swiss chiropractic PBRN through scanning a Quick Response (QR) code with either a phone or provided tablet.…”

The Swiss chiropractic practice-based research network: a population-based cross-sectional study to inform future musculoskeletal research

“…This included members with clinical practice locations in Switzerland and Liechtenstein. Further details of the study methods, including the patient and public involvement strategy are provided in the published study protocol 22 .…”

“…For this question, participants were asked "On a scale from 0-100 how motivated are you to participate in the patient cohort phase of the Swiss ChiCo pilot study". A pragmatic decision was made a-priori to identify clinicians who reported a well above medium interest to participate in the Swiss ChiCo pilot study based on a VAS score of ≥ 70 (hereafter denoted as "motivated PBRN participants") 22 . Only motivated PBRN participants were contacted for subsequent Swiss ChiCo pilot study recruitment.…”