Does a tailored guideline implementation strategy have an impact on clinical physiotherapy practice? A nonrandomized controlled study.

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Clinical Guidelines
Authored By
Bernhardsson S, Larsson MEH
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Orthopedic
Internal/Family Medicine
Speciality
Orthopedic
Internal/Family Medicine
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volume
25
ISSN
1365-2753
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ISSN
1365-2753
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true
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["Bernhardsson S, Larsson MEH","Publisher: Wiley-Blackwell Country of Publication: England NLM ID: 9609066 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1365-2753 (Electronic) Linking ISSN: 13561294 NLM ISO Abbreviation: J Eval Clin Pract Subsets: MEDLINE","Journal Article","2019-08-01","Journal of evaluation in clinical practice [J Eval Clin Pract] 2019 Aug; Vol. 25 (4), pp. 575-584. Date of Electronic Publication: 2018 May 28.","English","1365-2753","Attitude of Health Personnel* , Critical Pathways*\/organization & administration , Critical Pathways*\/standards , Evidence-Based Practice*\/methods , Evidence-Based Practice*\/standards , Physical Therapists*\/psychology , Physical Therapists*\/statistics & numerical data , Physical Therapy Modalities*, Musculoskeletal Diseases\/*therapy, Adult ; Delivery of Health Care\/methods ; Female ; Humans ; Male ; Middle Aged ; Practice Guidelines as Topic ; Reproducibility of Results ; Sweden","Adult, Delivery of Health Care methods, Female, Humans, Male, Middle Aged, Practice Guidelines as Topic, Reproducibility of Results, Sweden, Attitude of Health Personnel, Critical Pathways organization & administration, Critical Pathways standards, Evidence-Based Practice methods, Evidence-Based Practice standards, Musculoskeletal Diseases therapy, Physical Therapists psychology, Physical Therapists statistics & numerical data, Physical Therapy Modalities","Journal of evaluation in clinical practice","25"]
Description
Rationale, Aims, and Objectives: Clinical practice guidelines are a common strategy for implementing research findings into practice and facilitating evidence-based practice in health care settings. There is a paucity of knowledge about the impact of different guideline implementation strategies on clinical practice in a physiotherapy context. The study aimed to assess the impact of a guideline implementation intervention on clinical physiotherapy practice.<br />Methods: A tailored, multicomponent guideline implementation was compared with usual practice. Clinical practice was evaluated in physiotherapy treatment methods used for 3 common musculoskeletal disorders. Data were collected with a validated web-based questionnaire.<br />Results: Postimplementation data were collected from 168 physiotherapists in the intervention group and 88 in the control group. The most frequently reported treatment methods for low back pain were advice on posture (reported by 95% in the intervention group vs 90% in the control group), advice to stay active (93% vs 90%), and stabilization exercise (88% vs 80%). Differences between groups were not significant. Reported use of body awareness training (23% vs 6%, P = .023) and spinal manipulation (9% vs 23%, P = .044) differed between the groups. The most frequently used treatment methods for neck pain were advice on posture (95% vs 92%), advice to stay active (89% vs 87%), and ROM exercise (85% vs 71%) (no significant differences between groups). Reported use of body awareness training (24% vs 7%, P = .023) differed between the groups. The most frequently used treatment methods for subacromial pain were range of motion exercises (reported by 93% in both groups), advice on posture (90% vs 87%), home exercise (77% vs 74%), and stabilization exercise (69% vs 66%) (no significant difference between groups).<br />Conclusions: Treatment methods used were largely in line with evidence already before the guideline implementation, which may explain why the guideline implementation had only little impact on clinical practice.<br /> (© 2018 John Wiley & Sons, Ltd.)
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