Clinical Practice Guidelines for Neck and Low Back Pain in Outpatient Physical Therapy
| Status: | Recruiting |
|---|---|
| Conditions: | Back Pain, Back Pain, Orthopedic, Pain |
| Therapuetic Areas: | Musculoskeletal, Orthopedics / Podiatry |
| Healthy: | No |
| Age Range: | 18 - 85 |
| Updated: | 3/16/2019 |
| Start Date: | August 14, 2018 |
| End Date: | August 2020 |
| Contact: | Mallorey Smith |
| Email: | mallorey.smith@brooksrehab.org |
| Phone: | 904-345-8970 |
Health System Implementation of Clinical Practice Guidelines for Neck and Low Back Pain in Outpatient Physical Therapy Settings
This study will investigate implementation of a process to enhance Clinical Practice
Guideline (CPG) adherence to limit unwarranted variability in initial treatment decisions
with high potential for providing more effective and efficient physical therapy management
for patients with neck and low back pain.
Guideline (CPG) adherence to limit unwarranted variability in initial treatment decisions
with high potential for providing more effective and efficient physical therapy management
for patients with neck and low back pain.
Effective implementation of CPGs to augment initial clinical decision making during physical
therapy management of patients with spine related musculoskeletal pain will have several
important goals: 1) improve patient pain and disability outcomes, 2) limit over utilization
of physical therapy services, and 3) increase adherence to limit unwarranted variation in
clinical practice. This proposed pilot study proposal will test if a multifaceted
intervention strategy for implementation of neck and low back CPG meets these goals and
provide necessary data for larger system wide implementation efforts.
Specific Aim 1: Determine if physical therapy clinics that receive neck and low back pain
(LBP) clinical practice guideline (CPG) training are associated with improved patient
outcomes compared to those that have not received training. Neck and LBP specific disability
and pain intensity will be assessed at intake, on a weekly basis and at discharge (Specific
Aim 1a). Secondary patient outcomes will consist of patient satisfaction scores (Specific Aim
1b). Statistical analyses will evaluate for temporal effects of training considering the
stepped wedge study design.
Specific Aim 2: Determine if multifaceted interventions for CPG implementation positively
impacts physical therapist beliefs, attitudes, knowledge and behaviors over time. CPG
adherence (by clinicians) will be indirectly assessed using quantitative and qualitative
methods consisting of: 1) clinician checklists, 2) clinician questionnaires, 3) quality
indicators, and 4) total proportion outcome measure assessments (Specific Aim 2).
therapy management of patients with spine related musculoskeletal pain will have several
important goals: 1) improve patient pain and disability outcomes, 2) limit over utilization
of physical therapy services, and 3) increase adherence to limit unwarranted variation in
clinical practice. This proposed pilot study proposal will test if a multifaceted
intervention strategy for implementation of neck and low back CPG meets these goals and
provide necessary data for larger system wide implementation efforts.
Specific Aim 1: Determine if physical therapy clinics that receive neck and low back pain
(LBP) clinical practice guideline (CPG) training are associated with improved patient
outcomes compared to those that have not received training. Neck and LBP specific disability
and pain intensity will be assessed at intake, on a weekly basis and at discharge (Specific
Aim 1a). Secondary patient outcomes will consist of patient satisfaction scores (Specific Aim
1b). Statistical analyses will evaluate for temporal effects of training considering the
stepped wedge study design.
Specific Aim 2: Determine if multifaceted interventions for CPG implementation positively
impacts physical therapist beliefs, attitudes, knowledge and behaviors over time. CPG
adherence (by clinicians) will be indirectly assessed using quantitative and qualitative
methods consisting of: 1) clinician checklists, 2) clinician questionnaires, 3) quality
indicators, and 4) total proportion outcome measure assessments (Specific Aim 2).
Inclusion Criteria:
- 18 years of age or older
- Receiving outpatient physical therapy for a diagnosis covered in previously published
CPGs for neck or LBP
- Able to read and comprehend English language (necessary for completion of self-report
e-forms)
Exclusion Criteria:
- Any diagnosis indicating systemic involvement
- Widespread chronic pain syndrome
- Neuropathic pain syndromes
- Neurological disorders.
We found this trial at
1
site
Click here to add this to my saved trials
