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 .
Diagnostic Imaging Guidelines Implementation Study for Spinal Disorders: A Randomized Trial with Postal Follow-ups.
PURPOSE Implementation strategies of imaging guidelines can assist in reducing the number of radiographic examinations . This study aim ed to compare the perceived need for diagnostic imaging before and after an educational intervention strategy . METHODS One hundred sixty Swiss chiropractors attending a conference were r and omized to either receive a radiology workshop , review ing appropriate indications for diagnostic imaging for adult spine disorders ( n = 80 ) , or be in a control group ( CG ) . One group of 40 individuals dropped out from the CG due to logistic reasons . Participants in the intervention group were r and omly assigned to three subgroups to evaluate the effect of an online reminder at midpoint . All participants underwent a pretest and a final test at 14 - 16 weeks . A posttest was administered to two subgroups at 8 - 10 weeks . RESULTS There was no difference between baseline scores , and overall scores for the pretest and the final tests for all four groups were not significantly different . However , the subgroup provided with access to a reminder performed significantly better than the subgroup with whom they were compared ( F = 4.486 ; df = 1 and 30 ; p = .043 ) . Guideline adherence was 50.5 % ( 95 % CI , 39.1 - 61.8 ) for the intervention group and 43.7 % ( 95 % CI , 23.7 - 63.6 ) for the CG at baseline . Adherence at follow-up was lower , but mean group differences remained insignificant . CONCLUSIONS Online access to specific recommendations while making a clinical decision may favorably influence the intention to either order or not order imaging studies . However , a didactic presentation alone did not appear to change the perception for the need of diagnostic imaging studies
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 .