The effectiveness of a posted information package on the beliefs and behavior of musculoskeletal practitioners the UK chiropractors, osteopaths, and musculoskeletal hysiotherapists Low Back Pain Management (COMPLeMENT) randomized trial
Evans, David W., Breen, Alan C., Pincus, Tamar, Sim, Julius, Underwood, M. (Martin) M.D., Vogel, Steven and Foster, Nadine E.. (2010) The effectiveness of a posted information package on the beliefs and behavior of musculoskeletal practitioners the UK chiropractors, osteopaths, and musculoskeletal hysiotherapists Low Back Pain Management (COMPLeMENT) randomized trial. Spine, Vol.35 (No.8). pp. 858-866. ISSN 0362-2436Full text not available from this repository.
Official URL: http://dx.doi.org/10.1097/BRS.0b013e3181d4e04b
Study Design. Randomized controlled trial.
Objective. To investigate the effect of a printed information package on the low back pain (LBP)-related beliefs and reported behavior of musculoskeletal practitioners (chiropractors, osteopaths, and musculoskeletal physiotherapists) across the United Kingdom.
Summary of Background Data. A substantial proportion of musculoskeletal practitioners in United Kingdom does not follow current LBP guideline recommendations.
Methods. In total, 1758 practitioners were randomly allocated to either of the 2 study arms. One arm was posted a printed information package containing guideline recommendations for the management of LBP (n = 876) and the other received no intervention (n = 882). The primary outcome measure consisted of 3 "quality indicators" ( activity, work, and bed-rest) relating to a vignette of a patient with LBP, in which responses were dichotomized into either "guideline-inconsistent" or "guideline-consistent." The secondary outcome was the practitioners' LBP-related beliefs, measured using the Health Care Providers Pain and Impairment Relationship Scale. Outcomes were measured at baseline and at 6 months.
Results. Follow-up at 6 months was 89%. The changes in reported behavior on the quality indicators were as follows: activity, odds ratio (OR) 1.29 (95% confidence interval, 1.03-1.61) and number needed to be treated (NNT), 19 (15-28); work, OR 1.35 (1.07-1.70) and NNT 19 (14-29); and bed-rest, OR 1.31 (0.97-1.76) and NNT 47 (33-103). The composite NNT for a change from guideline-inconsistent to guideline-consistent behavior on at least 1 of the 3 quality indicators was 10 (9-14). LBP-related beliefs were significantly improved in those who were sent the information package (P = 0.002), but only to a small degree (mean difference, 0.884 scale points; 95% confidence interval, 0.319-1.448).
Conclusion. Printed educational material can shift LBP-related beliefs and reported behaviors of musculoskeletal practitioners, toward practice that is more in line with guideline recommendations.
|Item Type:||Journal Article|
|Subjects:||R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
R Medicine > RC Internal medicine
|Divisions:||Faculty of Medicine > Warwick Medical School|
|Journal or Publication Title:||Spine|
|Publisher:||Lippincott Williams & Wilkins|
|Official Date:||15 April 2010|
|Number of Pages:||9|
|Page Range:||pp. 858-866|
|Access rights to Published version:||Restricted or Subscription Access|
|Funder:||Osteopathic Educational Foundation, Anglo-European College of Chiropractic TAM Club, General Osteopathic Council, British Chiropractic Association, National Institutes of Health Research (NIHR), UK|
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