Assessing adverse events associated with chiropractic care in preschool pediatric population: a feasibility study.

IF 2 4区 医学 Q2 REHABILITATION
Anne Dolbec, Chantale Doucet, Katherine A Pohlman, Stéphane Sobczak, Isabelle Pagé
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引用次数: 0

Abstract

Background: Manual therapies are commonly used by healthcare professionals when caring for children. However, few prospective studies have evaluated their adverse events (AEs). This study aims to assess the feasibility of a pragmatic prospective study aiming to report the immediate and delayed (48-hours post-treatment) AEs associated with manual therapies in children aged 5 or younger. Preliminary data on AEs frequency are also reported.

Methods: Between July 2021 and March 2022, chiropractors were recruited through purposive sampling and via a dedicated Facebook group for Quebec chiropractors interested in pediatrics. Legal guardians of patients aged 5 or younger were invited to fill out an online information and consent form. AEs were collected using the SafetyNET reporting system, which had been previously translated by the research team. Immediate AEs were collected through a questionnaire filled out by the legal guardian immediately after the treatment, while delayed AEs were collected through a questionnaire sent by email to the legal guardian 48 h after the treatment. Feasibility was assessed qualitatively through feedback from chiropractors and quantitatively through recruitment data.

Results: Overall, a total of 28 chiropractors expressed interest following the Facebook publication, and 5 participated. An additional two chiropractors were enrolled through purposive sampling. In total, 80 legal guardians consented to their child's participation, and data from 73 children were included for the analysis of AEs. At least one AE was reported in 30% of children (22/73), and AEs were mainly observed immediately following the treatment (16/22). The most common AEs were irritability/crying (11 children) or fatigue/tiredness (11 children). Feasibility analysis demonstrated that regular communication between the research team and clinicians, as well as targeting clinicians who showed great interest in pediatrics, were key factors for successful research.

Conclusion: Results suggest that it is feasible to conduct a prospective pragmatic study evaluating AEs associated with manual therapies in private practices. Direct communication with the clinicians, a strategic clinicians' recruitment plan, and the resulting administrative burden should be considered in future studies. A larger study is required to confirm the frequency of AEs reported in the current study.

Trial registration: ClinicalTrials.gov., NCT05409859, Registered on June 3 2022. https://clinicaltrials.gov/study/NCT05409859 .

评估与学龄前儿童脊骨神经治疗相关的不良事件:一项可行性研究。
背景:医护人员在护理儿童时通常会使用徒手疗法。然而,很少有前瞻性研究对其不良事件(AEs)进行评估。本研究旨在评估一项实用性前瞻性研究的可行性,该研究旨在报告与 5 岁或以下儿童手法治疗相关的即时和延迟(治疗后 48 小时)不良反应。此外,还报告了有关AEs频率的初步数据:方法:2021 年 7 月至 2022 年 3 月期间,通过有目的的抽样并通过专门为对儿科感兴趣的魁北克脊骨神经科医生开设的 Facebook 群组招募脊骨神经科医生。5岁或5岁以下患者的法定监护人受邀填写在线信息和同意书。AEs通过SafetyNET报告系统收集,该系统之前已由研究小组翻译。即刻发生的不良反应通过法定监护人在治疗后立即填写的调查问卷收集,而延迟发生的不良反应则通过在治疗 48 小时后通过电子邮件发送给法定监护人的调查问卷收集。可行性通过脊骨神经科医生的反馈进行定性评估,通过招募数据进行定量评估:结果:在 Facebook 发布后,共有 28 名脊骨神经科医生表示有兴趣参加,其中 5 人参加了此次活动。另有两名脊骨神经科医生通过有目的的抽样获得了参与资格。共有80名法定监护人同意其子女参与,73名儿童的数据被纳入AEs分析。30%的儿童(22/73)报告了至少一种不良反应,不良反应主要出现在治疗后不久(16/22)。最常见的不良反应是烦躁/哭闹(11 名儿童)或疲劳/疲倦(11 名儿童)。可行性分析表明,研究团队与临床医生之间的定期沟通以及以对儿科有浓厚兴趣的临床医生为目标是研究成功的关键因素:研究结果表明,开展前瞻性务实研究,评估私人诊所中与手法治疗相关的不良反应是可行的。在未来的研究中,应考虑与临床医生的直接沟通、战略性的临床医生招募计划以及由此产生的管理负担。需要进行更大规模的研究,以确认当前研究中报告的AEs频率:ClinicalTrials.gov., NCT05409859,注册日期:2022 年 6 月 3 日。https://clinicaltrials.gov/study/NCT05409859 。
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来源期刊
Chiropractic & Manual Therapies
Chiropractic & Manual Therapies Medicine-Complementary and Alternative Medicine
CiteScore
3.20
自引率
15.80%
发文量
48
审稿时长
20 weeks
期刊介绍: Chiropractic & Manual Therapies publishes manuscripts on all aspects of evidence-based information that is clinically relevant to chiropractors, manual therapists and related health care professionals. Chiropractic & Manual Therapies is an open access journal that aims to provide chiropractors, manual therapists and related health professionals with clinically relevant, evidence-based information. Chiropractic and other manual therapies share a relatively broad diagnostic practice and treatment scope, emphasizing the structure and function of the body''s musculoskeletal framework (especially the spine). The practices of chiropractic and manual therapies are closely associated with treatments including manipulation, which is a key intervention. The range of services provided can also include massage, mobilisation, physical therapies, dry needling, lifestyle and dietary counselling, plus a variety of other associated therapeutic and rehabilitation approaches. Chiropractic & Manual Therapies continues to serve as a critical resource in this field, and as an open access publication, is more readily available to practitioners, researchers and clinicians worldwide.
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