CROaM was a large scale, mixed methods study commissioned by the General Osteopathic Council to explore patients’ and practitioners’ experiences of adverse events and treatment reactions.

Questionnaire responses were analysed from 1,082 osteopaths and 1,387 patients, and qualitative interview data was collected from 24 osteopaths and 19 patients. The results indicated that minor short term treatment reactions were fairly common occurring in about 20 percent of consultations and serious adverse events were very rare.  The study also provided helpful information about how often and in what ways osteopaths gain consent.​ The overall purpose of the study was to document reported treatment reactions and adverse events; to provide a description of UK osteopaths' risk assessment and risk management; to describe and model osteopaths' and patients' perceptions and beliefs about adverse events and treatment reactions. The project also utilised short-term follow-up of patient outcomes to provide a narrative evaluation of the comparative risks and benefits of osteopathic treatment.

The value and need for this information arose from recent debate in the medical, scientific, lay and osteopathic press, specifically concerning the cost benefit and risk profile within osteopathy. More importantly, there was little existing information about adverse events associated with osteopathic treatment. Osteopaths also expressed concerns about adherence to elements of their Code of Practice in this area; these largely related to their ability to manage risk and give patients accurate and relevant information for the purposes of receiving consent from patients.

The aims of the research were to:

  • Determine the frequency and impact of treatment reactions and adverse events;
  • Provide information about risk management and assessment from patients' and osteopaths' perspectives;
  • Provide a framework to interpret adverse events from the perspective of patients and osteopaths;
  • Provide a baseline for guidance in this area, grounded in the available evidence, and provide a risk versus benefit context for osteopathic practice.

The research has now been completed and approved by the GOsC. A summary report of the CROaM Project can be downloaded from this page.

Extra information

Steven Vogel, UCO Research
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