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Physical therapists' clinical knowledge of multidisciplinary low back pain treatment guidelines

Numerous clinical practice guidelines (CPGs) have been developed to
assist clinicians in care options for low back pain (LBP). Knowledge of CPGs has
been marginal across health-related professions. The aims of this
study were: (1) to measure US-based physical therapists' knowledge of care
recommendations associated with multidisciplinary LBP CPGs and (2) to determine
which characteristics were associated with more correct responses. DESIGN: A
cross-sectional survey was conducted. METHODS: Consenting participants attending
manual therapy education seminars read a clinical vignette describing a patient
with LBP and were asked clinical decision-making questions regarding care,
education, and potential referral. Descriptive statistics illustrating response
accuracy and binary logistic regression determined adjusted associations between
predictor variables and appropriate decisions. RESULTS: A total of 1,144 of 3,932
surveys were eligible for analysis. Correct responses were 55.9% for imaging,
54.7% for appropriate medication, 62.0% for advice to stay active, 92.7% for
appropriate referral with failed care, and 16.6% for correctly answering all 4
questions. After adjustment, practicing in an outpatient facility was
significantly associated with a correct decision on imaging. Female participants
were more likely than male participants to correctly select proper medications,
refer the patient to another health care professional when appropriate, and
answer all 4 questions correctly. Participants reporting caseloads of greater
than 50% of patients with LBP were more likely to select proper medications, give
advice to stay active, and answer all 4 questions correctly. Participants
attending more continuing education were more likely to give advice to stay
active and older, and more experienced participants were more likely to
appropriately refer after failed care. LIMITATIONS: There was potential selection
bias, which limits generalizability. CONCLUSIONS: The survey identified varied
understanding of CPGs when making decisions that were similar in recommendation
to the CPGs. No single predictor for correct responses for LBP CPGs was found.
CI - (c) 2014 American Physical Therapy Association.

Langue : ANGLAIS

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