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.
Spine (Phila Pa 1976)
; 35(8): 858-66, 2010 Apr 15.
Article
em En
| MEDLINE
| ID: mdl-20308941
ABSTRACT
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.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Padrões de Prática Médica
/
Guias de Prática Clínica como Assunto
/
Dor Lombar
/
Fidelidade a Diretrizes
/
Cultura
/
Educação Médica Continuada
Tipo de estudo:
Clinical_trials
/
Guideline
/
Prognostic_studies
/
Qualitative_research
Aspecto:
Determinantes_sociais_saude
Limite:
Humans
País/Região como assunto:
Europa
Idioma:
En
Revista:
Spine (Phila Pa 1976)
Ano de publicação:
2010
Tipo de documento:
Article
País de afiliação:
Reino Unido