Meta-analyses did not reveal any differences in effect between multifaceted strategies and controls .
Conclusion This review showed that multifaceted strategies for the implementation of neck and /or back pain guidelines in health care do not significantly improve professional behaviour outcomes .
No effects on patient outcomes or cost of care could be found .
Background For the optimal use of clinical guidelines in daily practice , mere distribution of guidelines and material s is not enough , and active implementation is needed .
This review investigated the effectiveness of multifaceted implementation strategies compared to minimal , single , or no implementation strategy for the implementation of non-specific low back and /or neck pain guidelines in health care .
Study protocol of an economic evaluation of an extended implementation strategy for the treatment of low back pain in general practice: a cluster randomised controlled trial
Background In Denmark , guidelines on low back pain management are currently being implemented ; in association with this , a clinical trial is conducted . A health economic evaluation is carried out alongside the clinical trial to assess the cost-effectiveness of an extended implementation strategy to increase the general practitioners ' adherence to the guidelines . In addition to usual dissemination , the extended implementation strategy is composed of visits from a guideline facilitator , stratification tools , and feedback on guideline adherence . The aim of this paper is to provide the considerations on the design of the health economic evaluation . Methods / design The economic evaluation is carried out alongside a cluster r and omised controlled trial consisting of 60 general practice s in the North Denmark Region . An expected 1,200 patients between the age of 18 and 65 years with a low back pain diagnosis will be enrolled . The economic evaluation comprises both a cost-effectiveness analyses and a cost-utility analysis . Effectiveness measures include referral to secondary care , health-related quality of life measured by EQ-5D-5L , and disability measured by the Rol and Morris disability question naire . Cost measures include all relevant additional costs of the extended implementation strategy compared to usual implementation . The economic evaluation will be performed from both a societal perspective and a health sector perspective with a 12-month time horizon . Discussion It is expected that the extended implementation strategy will reduce the number of patients referred to secondary care . It is hypothesised that the additional upfront cost of extended implementation will be counterbalanced by improvements in clinical practice and patient-related outcomes , thereby rendering the extended implementation strategy cost-effective . Trial registration Clinical Trials.gov :
Meta-analyses did not reveal any differences in effect between multifaceted strategies and controls .
Conclusion This review showed that multifaceted strategies for the implementation of neck and /or back pain guidelines in health care do not significantly improve professional behaviour outcomes .
No effects on patient outcomes or cost of care could be found .
Background For the optimal use of clinical guidelines in daily practice , mere distribution of guidelines and material s is not enough , and active implementation is needed .
This review investigated the effectiveness of multifaceted implementation strategies compared to minimal , single , or no implementation strategy for the implementation of non-specific low back and /or neck pain guidelines in health care .