The Benefits and Limitations of Evidence-based Practice in Osteopathy

Bordoni, Bruno

doi:10.7759/cureus.6093

Cited by 9 publications

(8 citation statements)

References 36 publications

(46 reference statements)

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“…Evidence‐based practice (EBP) is considered as a healthcare problem‐solving approach in the clinical decision‐making process that integrates the best evidence from well‐designed studies with a clinician's practice expertise, and patient's preferences and values (Melnyk & Fineout‐Overholt, 2023). EBP is rooted in research that demands scientific literacy skills for the best clinical strategies (Bordoni, 2019). Implementation is a major step in the EBP process.…”

Section: Background and Significancementioning

confidence: 99%

Role of Magnet®‐recognized hospital nurse managers in implementing evidence‐based practice: A mixed‐method study

Mathew,

Cesario,

Malecha

et al. 2024

Worldviews Ev Based Nurs

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BackgroundHealthcare systems recognize evidence‐based practice (EBP) as the prestigious standard for providing safe and high‐quality patient care, nursing excellence, and Magnet Recognition. Despite the well‐documented benefits, implementation of EBP is inconsistent and remains elusive in the US and throughout the world and many patients still fail to receive evidence‐based care. The literature revealed a huge gap between nursing science and practice but provided evidence that nurse managers (NMs) had a pivotal leadership role in implementing EBP.AimTo gain a deeper understanding of Magnet‐recognized hospital nurse managers' (MRHNMs) leadership roles, the influencing factors, and their experience in implementing EBP to enhance EBP initiatives and sustain Magnet recognition.MethodThis mixed‐method study guided by Goodall's (Australasian Psychiatry, 2016. 24, 231) theory of expert leadership used a sequential explanatory method with a quantitative‐driven design based on a national correlational survey augmented by a qualitative descriptive component using semi‐structured interviews.ResultsThe findings of the study demonstrated that MRHNMs had a 54.6% effective leadership role in implementing EBP and produced numerous themes indicating that MRHNMs did implement EBP with struggle. MRHNMs in this study viewed EBP as a healthcare priority and leadership of NMs is necessary to promote EBP. However, lack of knowledge, difficulties with the EBP process, time constraints, and staffing issues negatively impacted EBP. Postgraduate degree, formal EBP education, critical care units as workplace, collaboration with doctorally prepared nurses, and Magnet culture enhanced EBP among MRHNMs.Linking Evidence to ActionEBP is essential for Magnet recognition and is a hallmark of nursing excellence, however, is a complex and challenging process. The leadership of NMs is necessary to shape evidence‐based care, and NMs require EBP preparation during leadership training, necessary resources, and time to complete the EBP process. EBP cannot become a reality without leaders being engaged, supportive, and persistent.

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Section: Background and Significancementioning

confidence: 99%

Role of Magnet®‐recognized hospital nurse managers in implementing evidence‐based practice: A mixed‐method study

Mathew,

Cesario,

Malecha

et al. 2024

Worldviews Ev Based Nurs

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“…Clinical attentiveness, respect for patients, moral judgement, and ethics-driven conscience accompany and strengthen technical expertise in exceptional evidence-based practice. 61 Osteopathic manual medicine (OMM) practitioners participating in surveys regarding attitudes, skills, and evidence-based practice among osteopathic practitioners largely agree that evidence-based practice improves patientoriented decision-making and patient outcomes and is necessary for the clinical application of osteopathy. [62][63][64] Of note, most respondents in the literature available on this topic indicate a perceived lack of clinical evidence in osteopathic practice and an interest in improving these skills.…”

Section: Omt In Cids: Promising Clinical Strategies and Challengesmentioning

confidence: 99%

Osteopathic manipulative treatment for chronic inflammatory diseases

Gillan,

Bachtel,

Webber

et al. 2024

J Evidence Based Medicine

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Chronic inflammatory diseases (CIDs) are debilitating and potentially lethal illnesses that affect a large proportion of the global population. Osteopathic manipulative treatment (OMT) is a manual therapy technique developed and performed by osteopathic physicians that facilitates the body's innate healing processes. Therefore, OMT may prove a beneficial anti‐inflammatory modality useful in the management and treatment of CIDs. This work aims to objectively evaluate the therapeutic benefits of OMT in patients with various CIDs. In this review, a structured literature search was performed. The included studies involving asthma, chronic obstructive pulmonary disease, irritable bowel syndrome, ankylosing spondylitis, and peripheral arterial disease were selected for this work. Various OMT modalities, including lymphatic, still, counterstain, and muscle energy techniques, were utilized. Control treatments included sham techniques, routine care, or no treatment. OMT utilization led to variable patient outcomes in individuals with pathologies linked to CID.

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“…The common problem with OMT research is that studies often have low power, low sample size, or questionable experimental design [8]. To better analyze the effects of osteopathic medical research with these limitations, meta-analysis serves as an approach to a more evidence-based method to find overall effects [9,10]. While individual studies can be inconclusive or have problems with following up on patients receiving treatment, the effect of these problems may be minimized through the inclusion of other studies with small samples.…”

Section: Introductionmentioning

confidence: 99%

Osteopathic Manipulation as a Method of Cortisol Modification: A Systematic Review

Thibaut¹,

Santarlas²,

Hoppes³

et al. 2023

Cureus

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The effectiveness of osteopathic manipulative treatment (OMT) in the modification of various hormones has been studied; however, there is still a need for quantitative measurements to determine how large of an influence exists. The goal of this meta-analysis is to investigate the implications OMT has on cortisol levels. A systematic literature search restricted to English was performed from October 2022 to November 2022 using Google Scholar, OSTMED.DR, and PubMed and included articles from 2000 onward. Articles were excluded if they did not include a measurement for the control group in their study. We identified 4120 studies for potential inclusion. Of these, a total of four studies met the inclusion criteria, with a total of 135 participants (N= 68 OMT, N= 67 control). Out of the 135 participants, 126 participants (N= 62 OMT, N= 64 control) made up the salivary cortisol studies, and the remaining nine participants made up the serum cortisol studies (OMT N= 6, control N= 3). The National Institutes of Health (NIH) bias assessment tool was utilized to measure the risk of bias. Standard mean differences were calculated for effect size. A mean difference in cortisol of 0.10μg/dl (-10μg/dl, 95%CI -0.15, -0.04) was found when comparing all pre-versus post-cortisol levels with OMT versus sham control groups. OMT demonstrated a 0.10μg/dl larger decrease in cortisol than sham control treatments. The standard mean difference was found to be -0.46 (95%CI -1.40, 0.48) making this finding a medium effect size without significance. Heterogeneity for the salivary analysis measured by I 2 was 0% indicating no significant heterogeneity across studies. When serum cortisol was included, heterogeneity stayed at 0%. A larger number of high-quality studies, especially those specific to serum cortisol, are recommended, to elucidate the relationship between OMT and cortisol. This research suggests OMT reduces cortisol more than sham treatment before versus after OMT treatment, and though the change is small when comparing after one treatment, it may have clinical usage if multiple OMT sessions are performed.

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The Benefits and Limitations of Evidence-based Practice in Osteopathy

Cited by 9 publications

References 36 publications

Role of Magnet®‐recognized hospital nurse managers in implementing evidence‐based practice: A mixed‐method study

Role of Magnet®‐recognized hospital nurse managers in implementing evidence‐based practice: A mixed‐method study

Osteopathic manipulative treatment for chronic inflammatory diseases

Osteopathic Manipulation as a Method of Cortisol Modification: A Systematic Review

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