Primary Reasons for Osteopathic Consultation: A Prospective Survey in Quebec

<div><p>Background</p><p>Osteopathy is an increasingly popular health care modality to address pain and function in the musculoskeletal system, organs and the head region, as well as functional somatic syndromes. Although osteopathy is recommended principally in guidelines for management of back pain, osteopaths' scope of practice is wide, albeit poorly defined. In order to understand better the practice of osteopathy, this study aimed to investigate the most common reasons for osteopathic consultations in clinical settings in Quebec.</p><p>Methods</p><p>A prospective survey of members of the Registre des ostéopathes du Québec was conducted to examine demographics in osteopathic practices, as well as patients' primary reasons for consultations over a two-week period. The questionnaire was devised following a literature review and refined and verified with two stages of expert input.</p><p>Results</p><p>277 osteopaths (60.1% response rate) responded to the survey notice. 14,002 patients' primary reasons for consultations were reported in completed questionnaires and returned by practicing osteopaths. Musculoskeletal pain located in the spine, thorax, pelvis and limbs was the most common reason for consultations (61.9%), with females consulting most commonly for cervical pain and males for lumbar pain. Perinatal and paediatric (11.8%), head (9.1%), visceral (5.0%) and general concerns (4.8%) were the other most common reasons for consultations. Preventive care represented the remaining 0.3%.</p><p>Interpretation</p><p>The nature of primary reasons for osteopathic consultations, coupled with documented satisfaction of patients with this approach, suggest a future for multidisciplinary collaborative health care including osteopathy. Results of this survey may contribute to informing physicians and others pending regulation of Quebec osteopaths, and also provide direction for future clinical research and guidelines development.</p></div

Frequencies of primary reason for paediatric consultations (Children <15 y, n = 1437).

<p>Frequencies of primary reason for paediatric consultations (Children <15 y, n = 1437).</p

Reasons for osteopathic consultation related to pain and dysfunction in spine, pelvis and limbs.

<p>95%CI: 95% confidence interval.</p><p>* All includes adults and children.</p>†<p><i>P</i>-value for differences between frequency of consultation according to patient gender. Statistically significant difference between genders' was defined as <i>p</i><0.001 using the Bonferroni correction due to multiple comparisons.</p><p>Reasons for osteopathic consultation related to pain and dysfunction in spine, pelvis and limbs.</p

Reasons for osteopathic consultation related to visceral region, head region, general concerns, preventive care, and perinatal and paediatric concerns.

<p>95%CI: 95% confidence interval.</p><p>* All includes men, women and children.</p>†<p><i>P</i>-value for differences in frequency of reason for consultation according to patient gender. Statistically significant difference between genders' was defined as <i>p</i><0.001 using the Bonferroni correction due to multiple comparisons.</p>‡<p>Abdominal pain, post-surgical adhesions, skin problems.</p>§<p>Hormonal balance, degenerative diseases, homeostasis and vitality, circulatory problems and depression.</p><p>Reasons for osteopathic consultation related to visceral region, head region, general concerns, preventive care, and perinatal and paediatric concerns.</p

Frequencies of primary reason of consultation for all patients (n = 14002).

<p>Frequencies of primary reason of consultation for all patients (n = 14002).</p

Enablers and barriers to the development of interprofessional collaboration between physicians and osteopaths: A mixed methods study

<p>Osteopathy is a complementary and alternative medicine (CAM) that is growing in popularity. Increasing numbers of parents are seeking pediatric osteopathic care in addition to conventional medical care. Information about the development of interprofessional collaboration (IPC) between these practitioners is scarce. This explanatory sequential mixed methods study aimed to explore enablers of and barriers to the development of IPC between physicians and osteopaths involved with pediatric patients in primary care in Quebec, Canada. Postal questionnaires about collaborative practices were first sent to all physicians and osteopaths working with pediatric patients in Quebec. Semi-structured individual interviews were then conducted with a subset of 10 physicians and 11 osteopaths. A total of 274 physicians (14%) and 297 osteopaths (42%) completed the survey. Forty-five percent (n = 122) of physicians reported that they referred at least one pediatric patient per month to an osteopath. Thirty-six percent (n = 96) of physicians and 41% (n = 122) of osteopaths indicated having professional relationships. Personal consultation, professional relationship, perceived utility of osteopathy and community practice were positively associated with osteopathic referrals. According to participants, the strongest enabler of the development of collaboration was positive clinical results reported by parents. Additional enablers included the osteopath having previous health professionals training such as physiotherapist, pediatric experience, mutual respect for professional boundaries and complementarity, perceived safety of osteopathy, and parents’ requests for collaboration. Barriers were the absence of a common language, the organizational and legal context, uncertainty regarding one another’s roles, lack of interprofessional interactions, and limited scientific evidence. These results related to enablers of and barriers to collaboration between physicians and osteopaths and the illustration of their dynamic interaction could be used to guide efforts to promote productive collaboration and safe patient-oriented care.</p