A RETROSPECTIVE STANDARDS BASED AUDIT AND PRACTITIONER QUESTIONNAIRE: THE IMPLEMENTATION OF THE NATIONAL INSTITUTE OF HEALTH AND CLINICAL EXCELLENCE LOW-BACK PAIN GUIDELINES BY MUSCULOSKELETAL OUT-PATIENT PHYSIOTHERAPISTS

NTL Southorn

doi:10.1302/1358-992X.95BSUPP_4.SBPR2011-004

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A RETROSPECTIVE STANDARDS BASED AUDIT AND PRACTITIONER QUESTIONNAIRE: THE IMPLEMENTATION OF THE NATIONAL INSTITUTE OF HEALTH AND CLINICAL EXCELLENCE LOW-BACK PAIN GUIDELINES BY MUSCULOSKELETAL OUT-PATIENT PHYSIOTHERAPISTS

Society for Back Pain Research (SBPR) Annual Meeting

NTL Southorn

A RETROSPECTIVE STANDARDS BASED AUDIT AND PRACTITIONER QUESTIONNAIRE: THE IMPLEMENTATION OF THE NATIONAL INSTITUTE OF HEALTH AND CLINICAL EXCELLENCE LOW-BACK PAIN GUIDELINES BY MUSCULOSKELETAL OUT-PATIENT PHYSIOTHERAPISTS

Southorn N. A RETROSPECTIVE STANDARDS BASED AUDIT AND PRACTITIONER QUESTIONNAIRE: THE IMPLEMENTATION OF THE NATIONAL INSTITUTE OF HEALTH AND CLINICAL EXCELLENCE LOW-BACK PAIN GUIDELINES BY MUSCULOSKELETAL OUT-PATIENT PHYSIOTHERAPISTS. Orthop Procs. 2013;95-B(SUPP_4):4-4. doi:10.1302/1358-992X.95BSUPP_4.SBPR2011-004

Southorn, NTL. “A RETROSPECTIVE STANDARDS BASED AUDIT AND PRACTITIONER QUESTIONNAIRE: THE IMPLEMENTATION OF THE NATIONAL INSTITUTE OF HEALTH AND CLINICAL EXCELLENCE LOW-BACK PAIN GUIDELINES BY MUSCULOSKELETAL OUT-PATIENT PHYSIOTHERAPISTS.” Orthopaedic Proceedings, vol. 95-B, no. SUPP_4, 2013, pp. 4-4., https://doi.org/10.1302/1358-992X.95BSUPP_4.SBPR2011-004

Southorn, N. (2013). A RETROSPECTIVE STANDARDS BASED AUDIT AND PRACTITIONER QUESTIONNAIRE: THE IMPLEMENTATION OF THE NATIONAL INSTITUTE OF HEALTH AND CLINICAL EXCELLENCE LOW-BACK PAIN GUIDELINES BY MUSCULOSKELETAL OUT-PATIENT PHYSIOTHERAPISTS. Orthopaedic Proceedings, 95-B(SUPP_4), 4-4. https://doi.org/10.1302/1358-992X.95BSUPP_4.SBPR2011-004

Southorn, N. (2013) “A RETROSPECTIVE STANDARDS BASED AUDIT AND PRACTITIONER QUESTIONNAIRE: THE IMPLEMENTATION OF THE NATIONAL INSTITUTE OF HEALTH AND CLINICAL EXCELLENCE LOW-BACK PAIN GUIDELINES BY MUSCULOSKELETAL OUT-PATIENT PHYSIOTHERAPISTS.” Orthopaedic Proceedings, 95-B(SUPP_4), pp. 4-4. Available at: https://doi.org/10.1302/1358-992X.95BSUPP_4.SBPR2011-004

Southorn, NTL. “A RETROSPECTIVE STANDARDS BASED AUDIT AND PRACTITIONER QUESTIONNAIRE: THE IMPLEMENTATION OF THE NATIONAL INSTITUTE OF HEALTH AND CLINICAL EXCELLENCE LOW-BACK PAIN GUIDELINES BY MUSCULOSKELETAL OUT-PATIENT PHYSIOTHERAPISTS.” Orthopaedic Proceedings 95-B, no. SUPP_4 (2013): 4-4. https://doi.org/10.1302/1358-992X.95BSUPP_4.SBPR2011-004

Southorn N. A RETROSPECTIVE STANDARDS BASED AUDIT AND PRACTITIONER QUESTIONNAIRE: THE IMPLEMENTATION OF THE NATIONAL INSTITUTE OF HEALTH AND CLINICAL EXCELLENCE LOW-BACK PAIN GUIDELINES BY MUSCULOSKELETAL OUT-PATIENT PHYSIOTHERAPISTS. Orthop Procs. 2013 Jan 1;95-B(SUPP_4):4-4. https://doi.org/10.1302/1358-992X.95BSUPP_4.SBPR2011-004

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Abstract

Background

In 2009, the National Institute for Health and Clinical Excellence (NICE) produced the guidance: Low back pain: early management of persistent non-specific low back pain aimed at general practitioners (GPs), consultants, and manual therapists in order to ensure all involved in the care of this complex and often debilitating condition are aware of the options most likely to yield a positive outcome.

Two years since the publication of the clinical guidance, services have had ample time to adapt and overcome early teething issues in order to deliver these guidelines.

Methods

A retrospective audit was carried out at an out-patient physiotherapy department. One-hundred notes were randomly selected from those who meet the NICE criteria, i.e. non-specific low back pain for six weeks to 12 months in duration. A questionnaire was developed to target National Health Service (NHS) musculoskeletal physiotherapists using electronic media, mail shot and professional networking (clinical interest) groups within the Chartered Society of Physiotherapy (CSP). Sixty-one completed questionnaires were returned detailing the barriers for implementation.

The results show that 75% of patients received NICE recommended care, and they improved by numerical rating scale (NRS) −3.89, while those who did not, improved by NRS −1.24 producing a significant difference of 2.654 (95% Confidence Interval 1.008–4.300), p≤0.002.

The main perceived barriers were too few follow-up slots, local policy, managerial demands, and inadequate training.

Conclusions

The conclusions are that while three-quarters of patients are receiving and benefiting from NICE recommended care, many practitioners feel departmental policy and procedures reduce compliance.