Effectiveness of strategies for implementing guideline-concordant care in low back pain: a systematic review and meta-analysis of randomised controlled trials

• Published in: EClinicalMedicine 2024-12, Vol.78, p.102916, Article 102916
• Main Authors: Zhao, Siya, Langford, Aili V., Chen, Qiuzhe, Lyu, Meng, Yang, Zhiwei, French, Simon D., Williams, Christopher M., Lin, Chung-Wei Christine
• Format: Article
• Language: English
• Subjects: Guideline-concordant care; Implementation strategy; Low back pain
• ISSN: 2589-5370; 2589-5370
• DOI: 10.1016/j.eclinm.2024.102916

International low back pain guidelines recommend providing education/advice to patients, discouraging routine imaging use, and encouraging judicious prescribing of analgesics. However, practice variation occurs and the effectiveness of implementation strategies to promote guideline-concordant care is unclear. This review aims to comprehensively evaluate the effectiveness of implementation strategies to promote guideline-concordant care for low back pain. Five databases (including MEDLINE, Embase, CINAHL, CENTRAL and PEDro were searched from inception until 22nd August 2024. Randomised controlled trials (RCTs) that evaluated strategies to promote guideline-concordant care (providing education/advice, discouraging routine imaging use, and/or reducing analgesic use) among healthcare professionals or organisations were included. Two reviewers independently conducted screening, data extraction, and risk of bias assessments. The primary outcome was guideline-concordant care in the medium-term (>3 months but