title: The Nordic maintenance care program: what is maintenance care? Interview based survey of Danish chiropractors.
abstract: OBJECTIVE
  To describe and interpret Danish Chiropractors' perspectives regarding the purpose and rationale for using MC (maintenance care), its content, course and patient characteristics.
  
  
  METHODS
  Semi-structured interviews were conducted with 10 chiropractors identified using a stratified, theoretical sampling framework. Interviews covered four domains relating to MC, namely: purpose, patient characteristics, content, and course and development. Data was analysed thematically.
  
  
  RESULTS
  Practitioners regard MC primarily as a means of providing secondary or tertiary care and they primarily recommend it to patients with a history of recurrence. Initiating MC is often a shared decision between clinician and patient. The core elements of MC are examination and manipulation, but exercise and general lifestyle advice are often included. Typically, treatment intervals lie between 2 and 4 months. Clinician MC practices seem to evolve over time and are informed by individual practice experiences.Chiropractors are more likely to offer MC to patients whose complaints include a significant muscular component. Furthermore, a successful transition to MC appears dependent on correctly matching complaint with management. A positive relationship between chiropractor and patient facilitates the initiation of MC. Finally; MC appears grounded in a patient-oriented approach to care rather than a market-oriented one.
  
  
  CONCLUSIONS
  MC is perceived as both a secondary and tertiary preventative measure and its practice appears grounded in the tenet of patient-oriented care. A positive personal relationship between chiropractor and patient facilitates the initiation of MC. The results from this and previous studies should be considered in the design of studies of efficacy.
authors: Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark. cmyburgh@health.sdu.dk.
authors: Corrie
authors: C
authors: Myburgh
authors: Dorthe
authors: D
authors: Brandborg-Olsen
authors: Hanne
authors: H
authors: Albert
authors: Lise
authors: L
authors: Hestbaek
references: Chiropr Man Therap. 2012 Aug 10;20(1):25
references: 22883475
references: Chiropr Osteopat. 2010 Mar 08;18:5
references: 20211006
references: J Occup Environ Med. 2011 Apr;53(4):396-404
references: 21407100
references: Chiropr Osteopat. 2009 Jul 12;17:7
references: 19594894
references: Pain Physician. 2012 Jul;15(3 Suppl):ES9-38
references: 22786464
references: Chiropr Osteopat. 2009 Jan 22;17:1
references: 19161611
references: Chiropr Osteopat. 2010 Sep 01;18:25
references: 20809940
references: JAMA. 2000 Jul 26;284(4):483-5
references: 10904513
references: Chiropr Osteopat. 2008 Jun 18;16:6
references: 18559119
references: J Manipulative Physiol Ther. 2004 Oct;27(8):509-14
references: 15510094
references: Chiropr Osteopat. 2009 Jun 17;17:5
references: 19534801
references: Spine (Phila Pa 1976). 2011 Aug 15;36(18):1427-37
references: 21245790
references: Chiropr Osteopat. 2008 May 08;16:3
references: 18466623
references: BMC Musculoskelet Disord. 2011 Feb 08;12:41
references: 21303529
references: Lancet. 2012 Dec 15;380(9859):2163-96
references: 23245607