Attitudes and perceptions of health care professionals concerning chiropractors and chiropractic practice: A Systematic Review

Abstract

Background

Chiropractic care often exists outside of national healthcare systems, with exceptions in some national settings. This situation has led to suboptimal interprofessional communication and referral, with implications for the provision of appropriate and efficient care. To find solutions, the attitudes and perceptions of other professions must be better understood. We conducted a systematic review to assess other healthcare professionals’ perceptions and attitudes towards chiropractors and chiropractic care.

Methods

The review was registered with PROSPERO (CRD42023403381). Reporting was guided by the PRISMA statement. A search was carried out on PubMed, CINAHL, AMED, Index of Chiropractic Literature (ICL) and MEDLINE in Jan 2021 and updated on Jan 2022, February 2023 and June 2024. We included qualitative and quantitative study designs, focusing on healthcare professionals' attitudes toward and perceptions of chiropractic. Methodological quality was assessed using the Centre for Evidence Based Medicine tools for qualitative and cross-sectional survey studies

Results

The search retrieved 245 articles, of which 43 were included for review. Studies had been conducted across multiple national jurisdictions A total of 10,108 participants were included across the studies, including primary and secondary healthcare professionals as well as healthcare students. Issues identified with influencing opinions of chiropractic practice included participants’ knowledge of chiropractic methods, scope of practice, interprofessional communication, research base, and education. While some participants reported a perception of positive clinical outcomes associated with chiropractic care, communication between healthcare professionals and chiropractors was often lacking. Attitudes towards chiropractic varied, with factors like knowledge, patient interest, and referrals influencing perceptions.

Conclusions

To improve interprofessional attitudes and perceptions, the chiropractic profession might prioritise increased communication and information access concerning contemporary chiropractic care with other health care professions including educational interventions. Mitigation of a persistent lack of reliable information may improve how the profession is perceived in general, reduce misinformation and increase the likelihood that patients will receive the joined-up care they need.