Compliance with clinical practice guidelines in family physicians managing worker's compensation board patients with acute lower back pain.
BACKGROUND
Family physician compliance with acute lower back pain clinical practice guidelines remains uncertain.


OBJECTIVE
To determine the degree of guideline compliance of family physicians managing patients with workers' compensation claims and acute mechanical lower back pain.


METHODS
Observational study.


METHODS
One hundred thirty-nine family physicians in British Columbia.


METHODS
Compliance with guideline recommendations for history, examination procedures, diagnostic testing and treatments.


METHODS
Physician workers' compensation board patient reports for acute lower back pain without leg symptoms and not greater than 2 to 3 weeks duration were scored for guideline adherence up until 12 weeks after onset.


RESULTS
Physicians demonstrated a high degree of compliance with the guideline-recommended history, examination procedures and medications, but low compliance with recommended imaging and many treatment recommendations.


CONCLUSIONS
Recently published clinical practice guidelines regarding the management of patients with acute mechanical lower back pain have not been fully implemented into the patterns of practice of the family physicians.
Bishop
Paul B
PB
Combined Neurosurgical and Orthopaedic Spine Program, Heather Pavilion, Vancouver General Hospital, Vancouver, BC, Canada. pbishop@vanhosp.bc.ca
Wing
Peter C
PC
D015670:Acupuncture Therapy / Q000379:methods; D000328:Adult; D000700:Analgesics / Q000627:therapeutic use; D001955:British Columbia; D003131:Combined Modality Therapy; D015444:Exercise; D005194:Family Practice / Q000592:standards* / Q000639:trends; D005260:Female; D019983:Guideline Adherence; D019538:Health Care Surveys; D006801:Humans; D017116:Low Back Pain / Q000175:diagnosis / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities / Q000379:methods; D010821:Physicians, Family; D010818:Practice Patterns, Physicians' / Q000592:standards* / Q000639:trends; D011787:Quality of Health Care; D012720:Severity of Illness Index; D014942:Workers' Compensation / Q000592:standards* / Q000639:trends
D000700:Analgesics