The Management of Headache in Chiropractic Care: A Health Services Research Investigation

Publication Type:
Thesis
Issue Date:
2020
Full metadata record
𝗔𝗢𝗺: To explore Australian chiropractors’ management of headache disorders and the profile and headache characteristics of those seeking headache management from chiropractors. π— π—²π˜π—΅π—Όπ—±: The study samples were obtained from the Australian Chiropractic Research Network (ACORN) database (n=2005) and member practitioners (n=1680). The three distinct phases for this study project include a detailed literature review (Phase One), to examine the prevalence and features of those who seek help from manual therapy (MT) providers for headache management. This was followed by survey information collected from Australian chiropractors (Phase Two), enabling measurement of the proportion of chiropractors who β€˜often’ manage migraine and the factors associated with this practice (n=1,869), followed by the analysis of the features of headache management provided by chiropractors and specifically of chiropractors who utilise International Classification of Headache Disorders (ICHD) primary headache classification criteria (n=381). A subsequent survey of patients (n=224) enabled analysis of the profile and headache features of those seeking help from ACORN practitioners (Phase Three). π—₯π—²π˜€π˜‚π—Ήπ˜π˜€: Phase One: Review of the international literature indicated the use of MT providers averaged 15.9% for those with migraine and 17.7% for those with non-migrainous headache disorders. Phase Two: A majority of surveyed chiropractors reported high migraine caseloads (n=990; 53.0%). Chiropractors with high migraine caseloads were more likely than other chiropractors to treat non-musculoskeletal disorders and multi-region spine pain. One in five new patients (21.1%) presented to chiropractors with a chief complaint of headache. Most chiropractors use ICHD criteria for the diagnosis of primary (84.6%) and secondary (90.4%) headaches. Chiropractors reported most often collaborating with complementary and alternative medicine providers and general practitioners for headache and to provide advice on headache triggers and lifestyle, stress management and utilise manual therapies for headache management. Chiropractors who utilise primary headache classification criteria were more likely to believe this practice improves decision-making about primary headache patient referral/co-management. Phase Three: Approximately one in five headache patients who seek help from chiropractors have discrete features of migraine (20.5%), tension-type headache (16.5%), and one in three have features of more than one headache type (33%). Higher levels of headache impact occurred in patients with mixed headache (65.3%) and migraine (61.7%). π—–π—Όπ—»π—°π—Ήπ˜‚π˜€π—Άπ—Όπ—»: Internationally, headache management is a substantial within chiropractic practice in many western countries. The findings of this study provide insights for healthcare providers, patients and policymakers about the headache management provided by chiropractors. These findings call for further research to ensure the quality and safety of headache management by this provider.
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