Does Adherence to the Guideline Recommendation for Active Treatments Improve the Quality of Care for Patients With Acute Low Back Pain Delivered by Physical Therapists?

Fritz, Julie M.; Cleland, Joshua A.; Brennan, Gerard

doi:10.1097/mlr.0b013e318070c6cd

Cited by 197 publications

(169 citation statements)

References 45 publications

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“…41,42 Yet there is a strong body of evidence suggesting a low level of adherence to guidelines in daily clinical practice. 43,44 Overall adherence to guideline-based care by PCPs has been recorded at 65%, a rate that has remained unchanged despite attempts to increase implementation of evidence-based care.…”

Section: Current Clinical Practicesmentioning

confidence: 99%

Conservative Spine Care: Opportunities to Improve the Quality and Value of Care

Kosloff

Elton

Shulman

et al. 2013

Population Health Management

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Low back pain (LBP) has received considerable attention from researchers and health care systems because of its substantial personal, social, work-related, and economic consequences. A narrative review was conducted summarizing data about the epidemiology, care seeking, and utilization patterns for LBP in the adult US population. Recommendations from a consensus of clinical practice guidelines were compared to findings about the current state of clinical practice for LBP. The impact of the first provider consulted on the quality and value of care was analyzed longitudinally across the continuum of episodes of care. The review concludes with a description of recently published evidence that has demonstrated that favorable health and economic outcomes can be achieved by incorporating evidence-informed decision criteria and guidance about entry into conservative low back care pathways. (Population Health Management 2013;16:390-396)

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Section: Current Clinical Practicesmentioning

confidence: 99%

Conservative Spine Care: Opportunities to Improve the Quality and Value of Care

Kosloff

Elton

Shulman

et al. 2013

Population Health Management

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“…The criteria were implemented to permit the evaluation of clinical outcomes. 12,15 that exceed measurement error. 16,17 The study protocol was approved by the Institutional Review Board of Intermountain Healthcare.…”

Section: Methods Participantsmentioning

confidence: 99%

“…15,30 CPT codes billed were categorized as "active þ manual therapy," "passive," or "allowed." Codes classified as active þ manual therapy indicated procedures consistent with clinical guidelines for neck pain and represent interventions such as stretching and strengthening exercises, centralization exercises, upper quarter and nerve mobilization procedures, and spinal manipulation and mobilization (97110, 97350, 97535, 97112, 97150, 97140).…”

Section: List Of Abbreviationsmentioning

confidence: 99%

Description of Common Clinical Presentations and Associated Short-Term Physical Therapy Clinical Outcomes in Patients With Neck Pain

Horn

Brennan

George

et al. 2015

Archives of Physical Medicine and Rehabilitation

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Neck pain is the second most common musculoskeletal disorder in population surveys and is associated with high injury and disability claims. 1,2 It is generally accepted that neck pain has a favorable course of care, 3 but there is variation in short-term outcomes in patients with neck pain. 3,4 Certain factors are known to be prognostic for the course of neck pain, and several interventions, including those provided by physical therapists, are likely to produce a favorable outcome. [5][6][7][8][9] Approximately 35% of persons with neck pain reported being seen by a physical therapist, the most frequently visited provider, 10 and evidence suggests that physical therapy can be an effective secondary prevention strategy for neck pain. 11 In recent years, organized efforts have been made to improve clinical outcomes and standardize physical therapy treatment, including using classification system approaches. Fritz and Brennan 12 supported that subgrouping patients with neck pain and providing interventions matched to the patient classification improves shortterm outcomes of pain and disability from physical therapy, but this approach has not been validated nor have other classification systems published in the literature been validated. 13,14 Therefore in this study, rather than introduce a new classification system, we wished to pragmatically examine a large cohort of patients with common clinical presentations of neck pain. The purposes of this study were to describe the demographics and Disclosures: none.

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“…Identifying gaps between guidelines and clinical practice has been helpful in other areas of healthcare by highlighting factors associated with poor compliance with recommendations and by increasing compliance with them [25][26]. Improved adherence to treatment guidelines is typically associated with better outcomes across a variety of diseases and health conditions [27][28].…”

Section: Introductionmentioning

confidence: 99%

The Veterans Health Administration’s traumatic brain injury clinical reminder screen and evaluation: Practice patterns

et al. 2016

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Abstract-The goals of this study were to describe clinical practice patterns associated with the Veterans Health Administration's (VHA's) Comprehensive Traumatic Brain Injury Evaluation (CTBIE) and determine whether practice patterns vary by patient, provider, or facility characteristics. Veterans (N = 614) who had initial healthcare visits between 2008 and 2011 and who had previously completed the VHA's traumatic brain injury (TBI) screen and subsequent CTBIE were drawn from a national database. Participants were primarily male (95%) with a mean age of 29.8 yr (standard deviation = 8). Chart reviews were conducted on a random sample of charts with completed CTBIEs from 21 sites. Using a cross-sectional design, patientand facility-specific variables were investigated as potential predictors of practice variation. During the study period, 79% of patients in this national sample were screened within 1 d of their initial healthcare visit and 65% were evaluated via CTBIE within 30 d of screening. Provider and participant characteristics were generally not associated with timeliness. The CTBIE was completed by individuals versus teams at comparable rates. Much of what occurred during the evaluation, beyond TBI-specific procedures, were medical assessments, such as review of medications and other substances.

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Does Adherence to the Guideline Recommendation for Active Treatments Improve the Quality of Care for Patients With Acute Low Back Pain Delivered by Physical Therapists?

Abstract: Adherence to the guideline recommendation for active care was associated with better clinical outcomes and reduced cost.

Cited by 197 publications

References 45 publications

Conservative Spine Care: Opportunities to Improve the Quality and Value of Care

Conservative Spine Care: Opportunities to Improve the Quality and Value of Care

Description of Common Clinical Presentations and Associated Short-Term Physical Therapy Clinical Outcomes in Patients With Neck Pain

The Veterans Health Administration’s traumatic brain injury clinical reminder screen and evaluation: Practice patterns

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