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 .
Improving the care for people with acute low-back pain by allied health professionals (the ALIGN trial): A cluster randomised trial protocol
Background Variability between clinical practice guideline recommendations and actual clinical practice exists in many areas of health care . A 2004 systematic review examining the effectiveness of guideline implementation interventions concluded there was a lack of evidence to support decisions about effective interventions to promote the uptake of guidelines . Further , the review recommended the use of theory in the development of implementation interventions . A clinical practice guideline for the management of acute low-back pain has been developed in Australia ( 2003 ) . Acute low-back pain is a common condition , has a high burden , and there is some indication of an evidence - practice gap in the allied health setting . This provides an opportunity to develop and test a theory-based implementation intervention which , if effective , may provide benefits for patients with this condition . Aims This study aims to estimate the effectiveness of a theory-based intervention  to increase allied health practitioners ' ( physiotherapists and chiropractors in Victoria , Australia ) compliance with a clinical practice guideline for acute non-specific low back pain ( LBP ) , compared with providing practitioners with a printed copy of the guideline . Specifically , our primary objectives are to establish if the intervention is effective in reducing the percentage of acute non-specific LBP patients who are either referred for or receive an x-ray  , and improving mean level of disability for patients three months post-onset of acute LBP . Methods The design of the study is a cluster r and omised trial . Restricted r and omisation was used to r and omise 210 practice s ( clusters ) to an intervention or control group . Practitioners in the control group received a printed copy of the guideline . Practitioners in the intervention group received a theory-based intervention developed to address prospect ively identified barriers to practitioner compliance with the guideline . The intervention primarily consisted of an educational symposium .  Patients aged 18 years or older who visit a participating practitioner for acute non-specific LBP of less than three months duration over a two-week data collection period , three months post the intervention symposia , are eligible for inclusion . Sample size calculations are based on recruiting between 15 to 40 patients per practice . Outcome assessors will be blinded to group allocation . Trial registration Australian New Zeal and Clinical Trials Registry ACTRN12609001022257 ( date registered 25th November 2009
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 .