| The effectiveness of a posted information package on the beliefs and behavior of musculoskeletal practitioners: the UK Chiropractors, Osteopaths, and Musculoskeletal Physiotherapists Low Back Pain ManagemENT (COMPLeMENT) randomized trial. | |
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MedLine Citation:
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PMID: 20308941 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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STUDY DESIGN: Randomized controlled trial. OBJECTIVE: To investigate the effect of a printed information package on the low back pain (LBP)-related beliefs and reported behavior of musculoskeletal practitioners (chiropractors, osteopaths, and musculoskeletal physiotherapists) across the United Kingdom. SUMMARY OF BACKGROUND DATA: A substantial proportion of musculoskeletal practitioners in United Kingdom does not follow current LBP guideline recommendations. METHODS: In total, 1758 practitioners were randomly allocated to either of the 2 study arms. One arm was posted a printed information package containing guideline recommendations for the management of LBP (n = 876) and the other received no intervention (n = 882). The primary outcome measure consisted of 3 "quality indicators" (activity, work, and bed-rest) relating to a vignette of a patient with LBP, in which responses were dichotomized into either "guideline-inconsistent" or "guideline-consistent." The secondary outcome was the practitioners' LBP-related beliefs, measured using the Health Care Providers Pain and Impairment Relationship Scale. Outcomes were measured at baseline and at 6 months. RESULTS: Follow-up at 6 months was 89%. The changes in reported behavior on the quality indicators were as follows: activity, odds ratio (OR) 1.29 (95% confidence interval, 1.03-1.61) and number needed to be treated (NNT), 19 (15-28); work, OR 1.35 (1.07-1.70) and NNT 19 (14-29); and bed-rest, OR 1.31 (0.97-1.76) and NNT 47 (33-103). The composite NNT for a change from guideline-inconsistent to guideline-consistent behavior on at least 1 of the 3 quality indicators was 10 (9-14). LBP-related beliefs were significantly improved in those who were sent the information package (P = 0.002), but only to a small degree (mean difference, 0.884 scale points; 95% confidence interval, 0.319-1.448). CONCLUSION: Printed educational material can shift LBP-related beliefs and reported behaviors of musculoskeletal practitioners, toward practice that is more in line with guideline recommendations. |
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Authors:
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David W Evans; Alan C Breen; Tamar Pincus; Julius Sim; Martin Underwood; Steven Vogel; Nadine E Foster |
Publication Detail:
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Type: Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Spine Volume: 35 ISSN: 1528-1159 ISO Abbreviation: Spine Publication Date: 2010 Apr |
Date Detail:
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Created Date: 2010-04-16 Completed Date: 2010-07-12 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7610646 Medline TA: Spine (Phila Pa 1976) Country: United States |
Other Details:
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Languages: eng Pagination: 858-66 Citation Subset: IM |
Affiliation:
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School of Health and Rehabilitation, Keele University, Staffordshire, United Kingdom. |
| Data Bank Information | |
Bank Name/Acc. No.:
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ISRCTN/ISRCTN77245761 |
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| MeSH Terms | |
Descriptor/Qualifier:
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Attitude of Health Personnel Attitude to Health Behavior Chiropractic / methods, statistics & numerical data, trends Culture* Data Collection Education, Medical, Continuing / methods*, statistics & numerical data Great Britain Guideline Adherence / statistics & numerical data, trends* Health Care Surveys Health Knowledge, Attitudes, Practice Health Personnel Humans Low Back Pain / psychology, therapy* Osteopathic Physicians / statistics & numerical data, trends Outcome Assessment (Health Care) Physical Therapy (Specialty) / methods, statistics & numerical data, trends Physician's Practice Patterns / statistics & numerical data, trends* Physician-Patient Relations Practice Guidelines as Topic* Quality Assurance, Health Care / methods Quality of Health Care / statistics & numerical data, trends Questionnaires Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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