Adapting low back pain guidelines within a multidisciplinary context: a process evaluation.

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Clinical Guidelines
Authored By
Harstall C, Taenzer P, Zuck N, Angus DK, Moga C, Scott NA
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Interests
Orthopedic
Internal/Family Medicine
Speciality
Orthopedic
Internal/Family Medicine
Book Detail
volume
19
ISSN
1365-2753
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ISSN
1365-2753
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true
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["Harstall C, Taenzer P, Zuck N, Angus DK, Moga C, Scott NA","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; Research Support, Non-U.S. Gov't","2013-10-01","Journal of evaluation in clinical practice [J Eval Clin Pract] 2013 Oct; Vol. 19 (5), pp. 773-81. Date of Electronic Publication: 2012 Jul 29.","English","1365-2753","Evidence-Based Medicine*\/methods , Evidence-Based Medicine*\/standards, Low Back Pain\/*therapy , Practice Guidelines as Topic\/*standards, Benchmarking\/methods ; Humans ; Primary Health Care\/standards ; Quality Improvement ; Surveys and Questionnaires","Benchmarking methods, Humans, Primary Health Care standards, Quality Improvement, Surveys and Questionnaires, Evidence-Based Medicine methods, Evidence-Based Medicine standards, Low Back Pain therapy, Practice Guidelines as Topic standards","Journal of evaluation in clinical practice","19"]
Description
Rationale, Aims and Objectives: The Alberta Ambassador Program (AAP) adapted seven clinical practice guidelines on low back pain (LBP) into a single guideline spanning the continuum of care from prevention and diagnosis through to treatment. The Ambassador adaptation process was evaluated to 1 Identify the major challenges encountered and successful strategies utilized; 2 Assess strengths and weaknesses by benchmarking it with the ADAPTE framework; and 3 Identify opportunities for improvement.<br />Method: External consultants reviewed the Ambassador and ADAPTE materials and conducted semi-structured telephone interviews with 29 participants from the AAP committees. All participants were asked about the major challenges encountered and potential areas for improvement.<br />Results: The response rate was 83% (29/35). There was strong consensus that the Ambassador guideline adaptation process was sound and rigorous all respondents indicated willingness to participate in further iterations of the Program. Key elements of success were identified. The main steps and sequence of the process were closely aligned with the ADAPTE framework, although the AAP incorporated additional enhancements which augmented the process. The main divergences between the two frameworks centred on the organizational structure and the methods used to overcome methodological difficulties.<br />Conclusion: The AAP successfully utilized existing stakeholder interest to create an overarching guideline for managing LBP across multiple primary care disciplines. The study highlighted the strengths and weaknesses of the Program, and identified practical strategies for improvement. Evaluating guideline adaptation processes is pivotal to ensuring that they continue to be an efficient, rigorous and practicable option for producing contextualized, clinically relevant guidelines.<br /> (© 2012 John Wiley & Sons Ltd.)
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