Priorities for Osteopathic Care (PROCare): Setting the Global Research Agenda

In October, HSU was pleased to celebrate the publication of the Priorities for Osteopathic Care (PROCare) study in BMJ Open.

Initiated by Professor Steven Vogel and Dr Jerry Draper-Rodi, and led by Professor Paul Vaucher, this landmark study aimed to understand what research mattered most to the osteopathic profession and is the largest and most comprehensive research consultation that the profession has seen.

This research engaged 2,229 people from 42 countries and included patients, practitioners, students, educators, researchers, and policymakers.

In this article, the research team reflect on this research: what drove it, what was discovered and what this means for the future of osteopathic care.

HSU at the Heart of International Osteopathic Research

In undertaking this research, we sought to answer a deceptively simple question: what should we be researching?

The answer, it turns out, reveals as much about how we think about research as it does about what we should study.

This was not just an HSU study, it was an international collaboration spanning three continents. But HSU’s leadership was present with nine of the sixteen co-authors affiliated with the university, reflecting our central position in advancing the evidence base for osteopathic care globally.

Led by Professor Paul Vaucher, the study brought together expertise from Italy, Spain, Portugal, Finland, France, and Switzerland, with the newly formed HSU’s Centre for Osteopathic Research and Leadership (CORaL).

The research was innovative not just in its scope but in its methodology. Rather than simply asking people what they wanted to research, an initial umbrella review of research priority-setting across healthcare, analysed how priorities are structured and categorised, and developed a completely new framework: the “PROCare Eye” that organises osteopathic research into seven principal domains, 28 subdomains, and 96 examples of specific research topics.

This framework was then validated by expert consensus and tested with practitioners and patient representatives before the international survey was launched in nine languages.

What we Discovered: Consensus and Complexity

The results were both reassuring and revealing:

• Across all countries and all stakeholder groups, patient safety emerged as the clear top priority. It was nominated by 82% of countries represented in the study.
• Physical activity and mobility ranked as the second-highest priority subdomain, with sedentary lifestyle prevention specifically selected by 51% of participants.
• Understanding the neurophysiological effects of osteopathic treatment was chosen by half of all respondents.

The message was clear: the profession wants research that makes practice safer, helps people move better, and explains how treatment actually works.

Exploring the Concept of Research Priorities

While everyone agreed on these top priorities, the research team discovered that people approach the very concept of research priorities in different ways. We identified three distinct profiles that cut across all professional boundaries:

• Conservatives, making up 43% of respondents, prioritise research that strengthens and promotes the profession. They want studies that demonstrate osteopathy’s value and establish its place in healthcare systems.
• Sceptics, representing 20% of participants, take a different view. They’re less concerned with promoting the profession and more focused on methodological rigour and evidence standards. They want research that meets the highest scientific standards, regardless of whether it promotes osteopathy.
• Enthusiasts, the remaining 37%, accord high importance to research across all domains. They’re open to multiple research perspectives, value societal priorities and public health, and see research opportunities everywhere.

Remarkably, these three approaches to priority-setting were found across all groups in the study as practitioners, patients, educators, researchers, and policymakers were represented in all three profiles.

This suggests that differences in how we value research are not about our professional roles but about our fundamental values and beliefs about what research should accomplish.

What this Means for the Future of Osteopathic Care

The implications of this research extend beyond academic interest. For the first time, we have a validated, internationally-recognised framework for evaluating osteopathic research priorities.

This matters because research funding is limited and the study enables us to prioritise future work.

For research funders, the PROCare framework offers evidence-based guidance for strategic investment. Patient safety, treatment mechanisms, and physical activity interventions represent areas where research funding will align with what stakeholders actually want to know.

But the discovery of three distinct priority-setting profiles suggests something else: funding panels need balanced representation. A panel dominated by conservatives will fund different research than one dominated by sceptics or enthusiasts. None of these perspectives is “wrong,” but each alone is incomplete.

For practitioners, the research offers validation that the research agenda is not being set disconnected from clinical reality. The priorities identified understanding how treatment works, making it safer, and helping patients move better. These are deeply practical concerns that emerge directly from clinical practice. This suggests that future research in these areas is more likely to produce findings that are actually relevant to day-to-day osteopathic care.

For patients, perhaps the most important finding is that their voices are heard and their priorities matter. Patient safety didn’t become the top priority by accident; it reflects a genuine consensus that research should first and foremost make care safer and more effective.

The strong emphasis on physical activity and mobility also reflects what patients tell us matters: they want to move, to function, to live their lives without pain limiting what they can do.

For educators, the PROCare framework provides a structure for teaching research literacy. Students can learn not just what research exists but what research should exist, and more importantly, how to think critically about why different people prioritise different questions. This work is already having an impact at HSU with students using the framework to organise their own direction and topic choices for their research in their programmes of study.

Access the Full Publication

Vaucher P, Carnes D, Hohenschurz-Schmidt D, Thomson O, Vogel S, Arienti C, Bright P, Alvarez Bustins G, Esteves J, Koch Esteves N, Fawkes C, Rinne S, Roura S, Treffel L, Wagner A, Draper-Rodi J. European research Priorities for Osteopathic Care (PROCare): a sequential exploratory investigation and survey. BMJ Open 2025;15:e100757. https://bmjopen.bmj.com/content/15/10/e100757

The PROCare study was funded by UK Research and Innovation (UKRI) through the “Enhancing Research Culture” grant, reflecting HSU’s commitment to evidence-based practice and research excellence.