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Compliance with clinical practice guidelines in family physicians managing worker's compensation board patients with
1Combined Neurosurgical and Orthopaedic Spine Program, Heather Pavilion, Vancouver General Hospital, Vancouver, BC, Canada. pbishop@vanhosp.bc.ca
Background Context:
Family physician compliance with acute lower back pain clinical practice guidelines remains uncertain.
Purpose:
To determine the degree of guideline compliance of family physicians managing patients with workers' compensation claims and acute mechanical lower back pain.
Study Design:
Observational study.
Patient Sample:
One hundred thirty-nine family physicians in British Columbia.
Outcome Measures:
Compliance with guideline recommendations for history, examination procedures, diagnostic testing and treatments.
Methods:
Physician workers' compensation board patient reports for acute lower back pain without leg symptoms and not greater than 2 to 3 weeks duration were scored for guideline adherence up until 12 weeks after onset.
Results:
Physicians demonstrated a high degree of compliance with the guideline-recommended history, examination procedures and medications, but low compliance with recommended imaging and many treatment recommendations.
Conclusions:
Recently published clinical practice guidelines regarding the management of patients with acute mechanical lower back pain have not been fully implemented into the patterns of practice of the family physicians.
