What's the harm? Results of an active surveillance adverse event reporting system for chiropractors and physiotherapists

PLoS One. 2024 Aug 19;19(8):e0309069. doi: 10.1371/journal.pone.0309069. eCollection 2024.

Abstract

This prospective, community-based, active surveillance study aimed to report the incidence of moderate, severe, and serious adverse events (AEs) after chiropractic (n = 100) / physiotherapist (n = 50) visit in offices throughout North America between October-2015 and December-2017. Three content-validated questionnaires were used to collect AE information: two completed by the patient (pre-treatment [T0] and 2-7 days post-treatment [T2]) and one completed by the provider immediately post-treatment [T1]. Any new or worsened symptom was considered an AE and further classified as mild, moderate, severe or serious. From the 42 participating providers (31 chiropractors; 11 physiotherapists), 3819 patient visits had complete T0 and T1 assessments. The patients were on average 50±18 years of age and 62.5% females. Neck/back pain was the most common presenting condition (70.0%) with 24.3% of patients reporting no condition/preventative care. From the patients visits with a complete T2 assessment (n = 2136 patient visits, 55.9%), 21.3% reported an AE, of which: 7.9% were mild, 6.2% moderate, 3.7% severe, 1.5% serious, and 2.0% had missing severity rating. The most common symptoms reported with moderate or higher severity were discomfort/pain, stiffness, difficulty walking and headache. This study provides valuable information for patients and providers regarding incidence and severity of AEs following patient visits in multiple community-based professions. These findings can be used to inform patients of what AEs may occur and future research opportunities can focus on mitigating common AEs.

MeSH terms

  • Adult
  • Aged
  • Chiropractic*
  • Female
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Neck Pain / epidemiology
  • Physical Therapists*
  • Prospective Studies
  • Surveys and Questionnaires

Grants and funding

The study was Canadian Institutes of Health Research, Alberta Innovates – Health Solutions, and the generosity of the Stollery Children’s Hospital Foundation and supporters of the Lois Hole Hospital for Women through the Women and Children’s Health Research Institute. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.