SAFETY AND EFFECTIVENESS OF CHIROPRACTIC CARE OF CHILDREN AGED 0 – 12 YEARS
FINDINGS FROM THE SAFE CARE VICTORIA REVIEW INTO THE SAFETY AND EFFECTIVENESS OF CHIROPRACTIC CARE OF CHILDREN AGED 0 – 12 YEARS
In March 2019 a review was undertaken by Safe Care Victoria (SCV) to identify the safety and effectiveness of spinal manipulative therapy performed by Chiropractors on children aged 0 -12 years. A review sought by Victorian Health Minister Jenny Mikakos who was concerned whether public safety was at risk. Interestingly it then became a review not only into safety but also effectiveness and limited only to Chiropractic treatment to children aged 0 – 12 years.
However, the recommendations of this review would affect all professions that are permitted to perform spinal manipulative therapy and therefore included Chiropractors, Osteopaths, Medical and Physiotherapists.
REVIEW OF HARM
The review aimed to identify any evidence of harm by employing Cochrane Australia to perform a literature review, collecting any patient complaints, reviewing practitioner notification data from bodies that register Australian complaints, Insurance claim data and feedback from stakeholders.
The following quote from the SCV report summarises the review of harm findings;
“This extensive search identified very little evidence of patient harm occurring in Australia. In particular, there were no patient complaints or practitioner notifications that arose from significant harm to a child following a spinal manipulation.”
There are very few health professions that would be able to report similar findings and it would be welcomed that a similar safety audit is performed for other professions that treat children aged 0 – 12 years. The Chiropractic profession is very proud of its impeccable safety record. The Hippocratic Oath undertaken by all Chiropractors includes the phrase ‘First Do No Harm’ and it is a statement that they try to uphold in practice with each and every patient. When it comes to care for paediatric patients the adjustments made are adapted to the size and physiological make up of the child always, which ensures that the Chiropractic care provided is safe.
REVIEW OF EVIDENCE
It was found by Cochrane Australia that the evidence of Chiropractic care in treating various conditions in children is poor due to the lack of studies that have been performed in Australia.
It is noted that the evidence shows a lack of effectiveness as such but more that there are insufficient studies available. This would likely be the case for other forms of treatment that are administered and recommended by other health professionals.
One of the recommendations of the review was that the Health Ministers consider whether relevant funding bodies specifically allocate funding for a priority targeted research call to address the evidence gap. The Australian Chiropractic Association and other relevant representative bodies would welcome this financial support.
With regard to the same evidence for medicine, commentator Dr James Chestnut DC reports:
“Let’s now also be honest about the available evidence for the medical management of children under 12 with these same health issues. … the evidence for effectiveness and safety of medical management was not reviewed by this panel. There seems to be an inexplicable lack of interest in evaluating the safety and effectiveness of medical interventions, especially for children. The presupposition is that medical management of these children with these conditions is evidence-based in terms of safety and effectiveness and thus the lack of research evidence of effectiveness regarding chiropractic management should result in the de facto conclusion that medical management is safer, more effective, and thus should be universally recommended. But is it? ….most of what goes on in medical paediatric clinical practice with respect to these health issues is also based on practitioner experience and patient preference. The ONE GLARING difference is in the area of evidence of potential harm….”
FINDINGS FROM THE PUBLIC CONSULTATION
This review received the largest number of submissions to date through Engage Victoria or any other public stakeholder engagement. The public of Australia responded in force and as Chiropractors, we thank all those that took the time to make a submission and appreciate their support. The number or responses indicates that this review was important to so many and that Chiropractic care was important for their family to be able to access.
99.7% (21,750) reported a positive experience
98% indicated that their child improved after treatment
87.3% indicated that their child was much improved after treatment
Of the 0.3% that reported a negative experience, none were associated with significant adverse events
Parents appreciated the time that their child’s Chiropractor took to listen to their child’s symptoms, engage with them and their child.
Many parent responses indicated that they strongly valued the freedom to choose the care they believed most suited to their family. This cannot be understated or ignored. As health care consumers in Australia, we enjoy the right to choose the treatment of choice and this needs to remain. We cannot allow others to dictate what treatment we must undertake and in this instance Chiropractic care to children aged from 0 – 12 years of age has found to be extremely safe and parent satisfaction is extraordinarily high. A record that is enviable for so many other health care providers and one that they should aspire to achieve.
To read the report findings in full please go to https://www.bettersafercare.vic.gov.au/sites/default/files/2019-10/20191024-Final%20Chiropractic%20Spinal%20Manipulation.pdf
If you are unsure whether chiropractic care could be beneficial to you or your child, please call our Chiropractic Centre and speak to one of our Chiropractors. You do not need a referral.
RESULTS FROM SAFE CARE VICTORIA REVIEW INTO SAFETY AND EFFECTIVENESS OF CHIROPRACTIC CARE FOR CHILDREN AGED 0 – 12 YEARS
Parents appreciated the time the Chiropractor took to listen to their child’s symptoms and to engage with them and their child. Parents strongly valued the freedom of parent’s choice when choosing the care they believed most suited to their family.
The evidence to support the use of chiropractic care for certain health conditions in children was found to be poor due to a lack of studies that have been performed in Australia. Not due to poor results in the studies, indicating that research studies need to be undertaken in the immediate future.
Banyan Chiropractic Centre