| Guidelines on Low-back Pain Disability: Interprofessional Comparison of use Between General Practitioners, Occupational Therapists and Physiotherapists. | |
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MedLine Citation:
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PMID: 22310094 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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ABSTRACT: Study Design. Individual semi-structured qualitative interviews.Objective. Evaluate barriers to use of management recommendations aimed at preventing low-back pain (LBP) disability with general practitioners (GPs), occupational therapists (OTs) and physiotherapists (PTs) working in Quebec (Canada), and identify areas of convergence and divergence between health professions.Summary of Background Data. Studies have demonstrated inadequacies of practices of clinicians with regards to LBP management and prevention of persistent disability. Barriers to use of evidence by clinicians should be evaluated to understand these inadequacies and develop implementation strategies.Methods. 16 PTs, 8 OTs and 8 GPs were recruited with different levels of experience and practice location (urban or rural). They were asked to follow management recommendations (CLIP guidelines) with a minimum of two patients. Individual semi-structured interviews were used to identify barriers to use. Barriers between health professions were compared. Results. Barriers to use were lesser for OTs and greater for GPs, with divergences among PTs. OTs agreed with the guidelines, found them compatible with their current practice, and believed using them would prevent persistent disability. GPs and PTs believed the guidelines did not provide enough information on the pathophysiological management of LBP. GPs believed it would be difficult to implement the guidelines in everyday practice. All three groups believed management recommendations could conflict with patient expectations.Conclusions. In order to address identified barriers, a process of care is proposed by fitting tasks with providers most compatible. GP task could focus on pain management through medication, red flag screening, encouragement to stay active, and reassurance. PT tasks could center on pain management, general exercise and encouragement to stay active. OT tasks could focus on disability prognosis, yellow flags management, and return to activity parameters. The efficacy of this process of care to prevent persistent LBP disability should be assessed in a trial. |
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Authors:
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Stéphane Poitras; Marie-José Durand; Anne-Marie Côté; Michel Tousignant |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-2-2 |
Journal Detail:
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Title: Spine Volume: - ISSN: 1528-1159 ISO Abbreviation: - Publication Date: 2012 Feb |
Date Detail:
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Created Date: 2012-2-7 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7610646 Medline TA: Spine (Phila Pa 1976) Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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School of Rehabilitation, University of Ottawa, Ottawa, Canada. School of Rehabilitation, Université de Sherbrooke, Sherbrooke, Canada. School of Rehabilitation, Université de Sherbrooke, Sherbrooke, Canada. School of Rehabilitation, Université de Sherbrooke, Sherbrooke, Canada. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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