Adherence to key domains in low back pain clinical guidelines: a cross-sectional study of Danish physiotherapists working in private clinics and public healthcare centres

TY - ABST

T1 - Adherence to key domains in low back pain clinical guidelines

T2 - The Society for Back Pain Research

AU - Christensen, Maja Husted

AU - Rossen, Camilla

AU - Jensen, Tue Secher

AU - Mikkelsen, Lone Ramer

AU - Rolving, Nanna

PY - 2019/9/5

Y1 - 2019/9/5

N2 - Background and purpose: Adherence to clinical guidelines produces greater improvement in disability in patients with low back pain (LBP), but a wide variation in physiotherapists' adherence has been documented repeatedly. The aim of the study was to investigate the adherence to National Clinical Guidelines for LBP among Danish physiotherapists with regard to three key guideline domains: 1) activity, 2) work, and 3) psychosocial risk factors. Additionally to investigate whether adherence differed between physiotherapists working in private clinics and physiotherapists working at public healthcare centres. Methods: A cross-sectional online survey was conducted with 817 Danish physiotherapists. Adherence to the three guideline domains was assessed using two vignettes. The difference in adherence between the groups was tested using the chi-squared test. Results: Response rate was 29%. The proportions of physiotherapists giving advice that was strictly in line with the guideline domains were 32% (activity), 16% (work) and 82% (psychosocial risk factors) for Vignette 1 and 6% (activity), 53% (work) and 60% (psychosocial risk factors) for Vignette 2. Physiotherapists working at public healthcare centres were more likely to manage patients strictly in line with National Clinical Guidelines for assessing the psychosocial risk factors. Regarding the two other domains, there was no significant difference between the two groups in terms of adherence. Conclusion: Overall, the participating Danish physiotherapists strictly adhered to only one out of three key domains. This confirms the importance of identifying barriers to implementation of the National Clinical Guidelines in physiotherapy care for patients with LBP, including implementation of the inherent bio-psychosocial model.

AB - Background and purpose: Adherence to clinical guidelines produces greater improvement in disability in patients with low back pain (LBP), but a wide variation in physiotherapists' adherence has been documented repeatedly. The aim of the study was to investigate the adherence to National Clinical Guidelines for LBP among Danish physiotherapists with regard to three key guideline domains: 1) activity, 2) work, and 3) psychosocial risk factors. Additionally to investigate whether adherence differed between physiotherapists working in private clinics and physiotherapists working at public healthcare centres. Methods: A cross-sectional online survey was conducted with 817 Danish physiotherapists. Adherence to the three guideline domains was assessed using two vignettes. The difference in adherence between the groups was tested using the chi-squared test. Results: Response rate was 29%. The proportions of physiotherapists giving advice that was strictly in line with the guideline domains were 32% (activity), 16% (work) and 82% (psychosocial risk factors) for Vignette 1 and 6% (activity), 53% (work) and 60% (psychosocial risk factors) for Vignette 2. Physiotherapists working at public healthcare centres were more likely to manage patients strictly in line with National Clinical Guidelines for assessing the psychosocial risk factors. Regarding the two other domains, there was no significant difference between the two groups in terms of adherence. Conclusion: Overall, the participating Danish physiotherapists strictly adhered to only one out of three key domains. This confirms the importance of identifying barriers to implementation of the National Clinical Guidelines in physiotherapy care for patients with LBP, including implementation of the inherent bio-psychosocial model.

M3 - Conference abstract for conference

Y2 - 5 September 2019

ER -