Carolin Bahns1,2, Lisa Happe3,4, Christian Thiel3,5, Christian Kopkow6,3. 1. Department of Therapy Science I, Brandenburg Technical University Cottbus - Senftenberg, Universitätsplatz 1, 01968, Senftenberg, Germany. carolin.bahns@b-tu.de. 2. Department of Applied Health Sciences, Division of Physiotherapy, University of Applied Sciences, Bochum, Germany. carolin.bahns@b-tu.de. 3. Department of Applied Health Sciences, Division of Physiotherapy, University of Applied Sciences, Bochum, Germany. 4. Department for Health Services Research, Assistance Systems and Medical Devices, Carl von Ossietzky University Oldenburg, Oldenburg, Germany. 5. Faculty of Sports Science, Training and Exercise Science, Ruhr-University Bochum, Bochum, Germany. 6. Department of Therapy Science I, Brandenburg Technical University Cottbus - Senftenberg, Universitätsplatz 1, 01968, Senftenberg, Germany.
Abstract
BACKGROUND: Low back pain (LBP) is one of the most common musculoskeletal disorders worldwide. The National Disease Management Guideline (NVL) "Non-specific LBP" is a practical decision-making aid for both physicians and non-medical professionals in Germany to improve quality of health care. Although LBP is the most frequent diagnosis resulting in physical therapy treatment, information on the current management of patients with LBP and guideline adherence is limited. The objective of this study was to evaluate the current physical therapy management of patients with LBP in Germany, and to explore guideline adherence to the NVL "Non-specific LBP" recommendations. METHODS: An online survey among physical therapists working in Germany was conducted based on the recommendations given in the NVL "Non-specific LBP". Participants were recruited using a snowball sampling approach and invited to complete the questionnaire. Guideline adherence was evaluated by comparing the survey findings with the recommendations of the NVL. RESULTS: In total, 1361 physical therapists (41 years of age (SD 11); 839 female, 514 male; 16 years of clinical experience (SD 10)) completed the survey. Fifty percent (n = 675) of our respondents adhered to the recommendations of the NVL on the therapeutic diagnostic process, and 72% (n = 973) to the recommendations concerning treatment. The guideline adherence across the entire management process (i.e., both diagnosis and treatment) of LBP was 38% (n = 513). German physical therapists predominantly provide active interventions, e.g., exercise therapy, but also use interventions with low or conflicting evidence, respectively. Massage and Kinesio Taping were frequently used despite being not recommended. Less than one third of study participants (n = 400, 29%) answered to know the NVL or had dealt with its recommendations. CONCLUSIONS: In the management of LBP, overall guideline adherence among German physical therapists was 38% with higher adherence in the treatment section than in the physical therapeutic diagnostic process. Widespread employment of implementation strategies and removal of existing barriers against the application of evidence-based guidelines could facilitate the transfer of scientific evidence into clinical practice and contribute to optimize the quality of health care. TRIAL REGISTRATION: German Clinical Trials Register (DRKS00012607). Registered 04 October 2017.
BACKGROUND:Low back pain (LBP) is one of the most common musculoskeletal disorders worldwide. The National Disease Management Guideline (NVL) "Non-specific LBP" is a practical decision-making aid for both physicians and non-medical professionals in Germany to improve quality of health care. Although LBP is the most frequent diagnosis resulting in physical therapy treatment, information on the current management of patients with LBP and guideline adherence is limited. The objective of this study was to evaluate the current physical therapy management of patients with LBP in Germany, and to explore guideline adherence to the NVL "Non-specific LBP" recommendations. METHODS: An online survey among physical therapists working in Germany was conducted based on the recommendations given in the NVL "Non-specific LBP". Participants were recruited using a snowball sampling approach and invited to complete the questionnaire. Guideline adherence was evaluated by comparing the survey findings with the recommendations of the NVL. RESULTS: In total, 1361 physical therapists (41 years of age (SD 11); 839 female, 514 male; 16 years of clinical experience (SD 10)) completed the survey. Fifty percent (n = 675) of our respondents adhered to the recommendations of the NVL on the therapeutic diagnostic process, and 72% (n = 973) to the recommendations concerning treatment. The guideline adherence across the entire management process (i.e., both diagnosis and treatment) of LBP was 38% (n = 513). German physical therapists predominantly provide active interventions, e.g., exercise therapy, but also use interventions with low or conflicting evidence, respectively. Massage and Kinesio Taping were frequently used despite being not recommended. Less than one third of study participants (n = 400, 29%) answered to know the NVL or had dealt with its recommendations. CONCLUSIONS: In the management of LBP, overall guideline adherence among German physical therapists was 38% with higher adherence in the treatment section than in the physical therapeutic diagnostic process. Widespread employment of implementation strategies and removal of existing barriers against the application of evidence-based guidelines could facilitate the transfer of scientific evidence into clinical practice and contribute to optimize the quality of health care. TRIAL REGISTRATION: German Clinical Trials Register (DRKS00012607). Registered 04 October 2017.
Entities:
Keywords:
Guideline; Guideline adherence; Low back pain; Physical therapy
Authors: Maurits van Tulder; Annette Becker; Trudy Bekkering; Alan Breen; Maria Teresa Gil del Real; Allen Hutchinson; Bart Koes; Even Laerum; Antti Malmivaara Journal: Eur Spine J Date: 2006-03 Impact factor: 3.134