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Development of an implementation strategy for physiotherapy guidelines on low back pain
Geertruida E Bekkering1, Arno J Engers, Michael Wensing
1Dutch Institute of Allied Health Care, PO Box 1161, 3800 BD Amersfoort, The Netherlands. bekkering@paramedisch.org
The Australian Journal of Physiotherapy
|September 4, 2003
Summary
Passive implementation strategies are ineffective for physiotherapy guidelines. A new, multi-component strategy addressing physiotherapists' knowledge gaps and practice discrepancies was developed for low back pain guidelines.
Area of Science:
- Health Professions Education
- Physical Therapy
- Implementation Science
Background:
- Clinical practice guidelines are often implemented passively in Dutch physiotherapy, leading to limited behavior change.
- Passive implementation strategies are ineffective for healthcare professionals.
Purpose of the Study:
- To describe the design method for a new implementation strategy for physiotherapy guidelines on low back pain.
- To address identified barriers and discrepancies in current physiotherapy practice.
Main Methods:
- A survey of 100 physiotherapy practices identified barriers and practice-guideline discrepancies.
- A behavior change model and systematic reviews informed strategy development.
- The strategy incorporated education, discussion, role-playing, feedback, and reminders.
Main Results:
- Key barriers included physiotherapists' lack of knowledge or skills.
- Discrepancies involved focus on impairments, passive interventions, pain-contingent approaches, and patient expectations.
- The new strategy integrated multiple interventions to target these issues.
Conclusions:
- A comprehensive, multi-component implementation strategy is necessary to overcome barriers.
- Addressing specific knowledge gaps and practice deviations is crucial for guideline adherence.
- This designed strategy aims to improve the implementation of low back pain physiotherapy guidelines.