OBJECTIVE: To evaluate the effects of an active strategy to implement the Dutch physiotherapy guideline on low back pain. METHODS: A cluster-randomised controlled trial was performed to compare the effects of an active and standard intervention strategy for guideline implementation on adherence to the guideline and patient outcomes. One hundred-thirteen physiotherapists were allocated at random to receive the active or the standard implementation strategy. The active strategy was a multifaceted intervention that consisted of education, discussion, role-playing feedback, and reminders. Guideline adherence was evaluated by means of a form on which physiotherapists registered the treatment they gave each patient. Two people assessed whether the treatment was performed according to the guideline, using the four most important recommendations of the guideline. Patient outcomes were assessed using questionnaires on physical functioning, pain, sick leave, pain coping, and back pain beliefs. Multilevel regression analysis was used to analyse the results. RESULTS: Five hundred patients were included in the trial. The physiotherapists in the intervention group treated patients more often in accordance with guideline recommendations than did physiotherapists in the standard strategy group. Although in the first 12 weeks patient outcomes in the two groups improved considerably, there was no difference between the two groups on physical functioning, pain, sick leave, pain coping, and back pain beliefs. CONCLUSION: The active strategy to implement the guideline on low back pain improves physiotherapist adherence to the guideline but does not result in additional improvements in patient outcomes.

There are no links to full text for this record.