TY - JOUR
T1 - Barriers to the use of clinical practice guidelines
T2 - a qualitative study of Danish physiotherapists and chiropractors
AU - Husted, Maja
AU - Rolving, Nanna
AU - Poulsen, Anne Grøndahl
AU - Jensen, Tue Secher
AU - Rossen, Camilla
PY - 2024
Y1 - 2024
N2 - Purpose: Low back pain (LBP) is the leading cause of disability worldwide. Providing evidence-based practice (EBP) for patients with LBP is more cost-effective compared with non-EBP. To help health care professionals provide EBP, several clinical practice guidelines have been published. However, a relatively poor uptake of the guidelines has been identified across various countries. To enhance future implementation of EBP, the aim of this study was to explore barriers to using LBP guidelines in clinical practice. Materials and methods: A qualitative constructivist grounded theory design was employed in order to gain an in-depth understanding of the barriers. Semi-structured interviews (+/− observations) of nine physiotherapists and nine chiropractors from primary care in the Central Denmark Region were conducted. Results: Two key barriers were found to using guidelines in practice: (1) a scepticism due to doubts about validity and applicability of the guidelines, which emerged particularly among physiotherapists; and (2) a deep biomechanical professional identity, due to perceived role, interest, lack of skills, and patient preferences, which emerged particularly among chiropractors. Conclusions: For guidelines to be better implemented in practice, these key barriers must be addressed in a tailored strategy. Furthermore, this study showed a difference in barriers between the two professions.
AB - Purpose: Low back pain (LBP) is the leading cause of disability worldwide. Providing evidence-based practice (EBP) for patients with LBP is more cost-effective compared with non-EBP. To help health care professionals provide EBP, several clinical practice guidelines have been published. However, a relatively poor uptake of the guidelines has been identified across various countries. To enhance future implementation of EBP, the aim of this study was to explore barriers to using LBP guidelines in clinical practice. Materials and methods: A qualitative constructivist grounded theory design was employed in order to gain an in-depth understanding of the barriers. Semi-structured interviews (+/− observations) of nine physiotherapists and nine chiropractors from primary care in the Central Denmark Region were conducted. Results: Two key barriers were found to using guidelines in practice: (1) a scepticism due to doubts about validity and applicability of the guidelines, which emerged particularly among physiotherapists; and (2) a deep biomechanical professional identity, due to perceived role, interest, lack of skills, and patient preferences, which emerged particularly among chiropractors. Conclusions: For guidelines to be better implemented in practice, these key barriers must be addressed in a tailored strategy. Furthermore, this study showed a difference in barriers between the two professions.
KW - Implementation
KW - barriers
KW - chiropractors
KW - clinical practice guidelines
KW - physiotherapists
KW - qualitative study
U2 - 10.1080/09638288.2022.2157501
DO - 10.1080/09638288.2022.2157501
M3 - Journal article
C2 - 36537245
SN - 0963-8288
VL - 46
SP - 105
EP - 114
JO - Disability and Rehabilitation
JF - Disability and Rehabilitation
IS - 1
ER -