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Does the implementation of clinical practice guidelines for low back and neck pain by physical therapists improve patient outcomes? A systematic review

BACKGROUND: Physical therapy for neck and low back pain is highly variable despite the availability of clinical practice guidelines (CPG). This review aimed to determine the impact of CPG implementation on patient-level outcomes for spinal pain. Implementation strategies were also examined to determ...

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Autores principales: Fillipo, Rebecca, Pruka, Katie, Carvalho, Marissa, Horn, Maggie E., Moore, Jordan, Ramger, Benjamin, Clewley, Derek
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9164354/
https://www.ncbi.nlm.nih.gov/pubmed/35659117
http://dx.doi.org/10.1186/s43058-022-00305-2
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author Fillipo, Rebecca
Pruka, Katie
Carvalho, Marissa
Horn, Maggie E.
Moore, Jordan
Ramger, Benjamin
Clewley, Derek
author_facet Fillipo, Rebecca
Pruka, Katie
Carvalho, Marissa
Horn, Maggie E.
Moore, Jordan
Ramger, Benjamin
Clewley, Derek
author_sort Fillipo, Rebecca
collection PubMed
description BACKGROUND: Physical therapy for neck and low back pain is highly variable despite the availability of clinical practice guidelines (CPG). This review aimed to determine the impact of CPG implementation on patient-level outcomes for spinal pain. Implementation strategies were also examined to determine prevalence and potential impact. METHODS: Multiple databases were searched through April 2021 for studies assessing CPG implementation in physical therapy for neck and low back pain. Articles were screened for eligibility. The Modified Downs and Black checklist was utilized to determine study quality. Due to the heterogeneity between studies, a meta-analysis was not performed. RESULTS: Twenty-one studies were included in this review. Implementation strategies were significantly varied between studies. Outcomes pertaining to healthcare utilization, pain, and physical functioning were assessed in relation to the implementation of CPGs. Multiple implementation strategies were identified, with Managing Quality as the most frequently utilized key implementation process. Findings indicate CPG implementation decreased healthcare utilization, but inconsistent results were found with physical functioning and pain outcomes. CONCLUSIONS: CPG implementation appears to have a beneficial effect on healthcare utilization outcomes, but may not impact pain and physical functioning outcomes. Effective CPG implementation strategies remain unknown, though utilizing implementation framework may improve outcomes. More research is needed to determine the most effective implementation strategies and effects on pain and physical function outcomes. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s43058-022-00305-2.
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spelling pubmed-91643542022-06-05 Does the implementation of clinical practice guidelines for low back and neck pain by physical therapists improve patient outcomes? A systematic review Fillipo, Rebecca Pruka, Katie Carvalho, Marissa Horn, Maggie E. Moore, Jordan Ramger, Benjamin Clewley, Derek Implement Sci Commun Systematic Review BACKGROUND: Physical therapy for neck and low back pain is highly variable despite the availability of clinical practice guidelines (CPG). This review aimed to determine the impact of CPG implementation on patient-level outcomes for spinal pain. Implementation strategies were also examined to determine prevalence and potential impact. METHODS: Multiple databases were searched through April 2021 for studies assessing CPG implementation in physical therapy for neck and low back pain. Articles were screened for eligibility. The Modified Downs and Black checklist was utilized to determine study quality. Due to the heterogeneity between studies, a meta-analysis was not performed. RESULTS: Twenty-one studies were included in this review. Implementation strategies were significantly varied between studies. Outcomes pertaining to healthcare utilization, pain, and physical functioning were assessed in relation to the implementation of CPGs. Multiple implementation strategies were identified, with Managing Quality as the most frequently utilized key implementation process. Findings indicate CPG implementation decreased healthcare utilization, but inconsistent results were found with physical functioning and pain outcomes. CONCLUSIONS: CPG implementation appears to have a beneficial effect on healthcare utilization outcomes, but may not impact pain and physical functioning outcomes. Effective CPG implementation strategies remain unknown, though utilizing implementation framework may improve outcomes. More research is needed to determine the most effective implementation strategies and effects on pain and physical function outcomes. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s43058-022-00305-2. BioMed Central 2022-06-03 /pmc/articles/PMC9164354/ /pubmed/35659117 http://dx.doi.org/10.1186/s43058-022-00305-2 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Systematic Review
Fillipo, Rebecca
Pruka, Katie
Carvalho, Marissa
Horn, Maggie E.
Moore, Jordan
Ramger, Benjamin
Clewley, Derek
Does the implementation of clinical practice guidelines for low back and neck pain by physical therapists improve patient outcomes? A systematic review
title Does the implementation of clinical practice guidelines for low back and neck pain by physical therapists improve patient outcomes? A systematic review
title_full Does the implementation of clinical practice guidelines for low back and neck pain by physical therapists improve patient outcomes? A systematic review
title_fullStr Does the implementation of clinical practice guidelines for low back and neck pain by physical therapists improve patient outcomes? A systematic review
title_full_unstemmed Does the implementation of clinical practice guidelines for low back and neck pain by physical therapists improve patient outcomes? A systematic review
title_short Does the implementation of clinical practice guidelines for low back and neck pain by physical therapists improve patient outcomes? A systematic review
title_sort does the implementation of clinical practice guidelines for low back and neck pain by physical therapists improve patient outcomes? a systematic review
topic Systematic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9164354/
https://www.ncbi.nlm.nih.gov/pubmed/35659117
http://dx.doi.org/10.1186/s43058-022-00305-2
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