[Efficiency of guidelines and educational program: a training process for the diagnosis of low back pain].
BACKGROUND
The Italian National Health Plan has included low back pain (LBP) among the pathologies for which clinical guidelines should be created and disseminated. A change in the clinical behaviour of doctors requires forms of intervention whose efficiency is not fully known.


OBJECTIVE
This study proposes to evaluate the efficacy of a multifaceted intervention, including educational materials, lectures, workshops and local consensus processes, in order to modify the General Practitioners' (GP) clinical treatment of LBP.


METHODS
Changes in diagnostic capacity have been evaluated through a controlled (before/after) trial based on the frequency of etiological diagnoses of LBP, the testing of clinical knowledge with multiple choice tests, and on priorities given in confronting problems of treatment of LBP by the three GP's groups that had voluntarily adhered to the study.


RESULTS
A statistically significant increase of diagnostic capacity (the frequency of exact responses in the multiple choice test) was achieved. There was also a shifting of priorities in confronting problems in the treatment of LBP, from the diagnosis as a primary issue before intervening, to communication with the patient.


CONCLUSIONS
Within the Italian context, the study also confirms the efficiency of a multifaceted intervention based on a training process aimed at modifying the clinical behaviour of the GP with respect to LBP.
Fabiani
Leila
L
Dipartimento di Medicina Interna e Sanità Pubblica, Università dell'Aquila.
Giovannoni
Stefano
S
Casanica
Marina
M
Scatigna
Maria
M
Pulsoni
Romeo
R
Ventriglia
Giuseppe
G
Marchi
Marco
M
D000328:Adult; D004501:Education, Medical; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000175:diagnosis* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic