Evaluation of a tailored, multi-component intervention for implementation of evidence-based clinical practice guidelines in primary care physical therapy: a non-randomized controlled trial

• Published in: BMC health services research 2014-03, Vol.14 (1), p.105-105, Article 105
• Main Authors: Bernhardsson, Susanne, Larsson, Maria E H, Eggertsen, Robert, Olsén, Monika Fagevik, Johansson, Kajsa, Nilsen, Per, Nordeman, Lena, van Tulder, Maurits, Öberg, Birgitta
• Format: Article
• Language: English
• Subjects: Adaptation; Adult; Allmän medicin; Clinical medicine; Clinical practice guidelines; Clinical trials; Councils; Data analysis; Evidence-Based Medicine - methods; Evidence-Based Medicine - standards; Evidence-Based Medicine - statistics & numerical data; Evidence-based practice; Family Medicine; Female; Guideline Adherence - statistics & numerical data; Health care; Health sciences; Humans; Intervention; Male; Middle Aged; Musculoskeletal Diseases - therapy; Neurosciences; Neurovetenskaper; Pain; Performance evaluation; Physical therapy; Physical Therapy Modalities - standards; Physical Therapy Modalities - statistics & numerical data; Physical Therapy Specialty - methods; Physical Therapy Specialty - standards; Physical Therapy Specialty - statistics & numerical data; Practice Guidelines as Topic; Pragmatism; Primary care; Primary Health Care - methods; Primary Health Care - standards; Primary Health Care - statistics & numerical data; R&D; Research & development; Studies; Surveys and Questionnaires; Sweden - epidemiology; Young Adult
• ISSN: 1472-6963; 1472-6963
• DOI: 10.1186/1472-6963-14-105

Clinical practice guidelines are important for transmitting research findings into practice and facilitating the application of evidence-based practice (EBP). There is a paucity of knowledge about the impact of guideline implementation strategies in primary care physical therapy. The aim of this study was to evaluate the effect of a guideline implementation intervention in primary care physical therapy in western Sweden. An implementation strategy based on theory and current evidence was developed. A tailored, multi-component implementation intervention, addressing earlier identified determinants, was carried out in three areas comprising 28 physical therapy practices including 277 physical therapists (PTs) (intervention group). In two adjacent areas, 171 PTs at 32 practices received no intervention (control group). The core component of the intervention was an implementation seminar with group discussions. Among other components were a website and email reminders. Data were collected at baseline and follow-up with a web-based questionnaire. Primary outcomes were the self-reported awareness of, knowledge of, access to, and use of guidelines. Secondary outcomes were self-reported attitudes toward EBP and guidelines. Analyses were performed using Pearson's χ2 test and approximative z-test. 168 PTs (60.6%) in the intervention group and 88 PTs (51.5%) in the control group responded to the follow-up questionnaire. 186/277 PTs (67.1%) participated in the implementation seminars, of which 97 (52.2%) responded. The proportions of PTs reporting awareness of (absolute difference in change 20.6%, p = 0.023), knowledge where to find (20.4%, p = 0.007), access to (21.7%, p