title: Adherence to clinical practice guidelines among three primary contact professions: a best evidence synthesis of the literature for the management of acute and subacute low back pain.
abstract: OBJECTIVE
  To determine adherence to clinical practice guidelines in the medical, physiotherapy and chiropractic professions for acute and subacute mechanical low back pain through best-evidence synthesis of the healthcare literature.
  
  
  METHODS
  A structured best-evidence synthesis of the relevant literature through a literature search of relevant databases for peer-reviewed papers on adherence to clinical practice guidelines from 1995 to 2013. Inclusion of papers was based on selection criteria and appraisal by two reviewers who independently applied a modified Downs & Black appraisal tool. The appraised papers were summarized in tabular form and analysed by the authors.
  
  
  RESULTS
  The literature search retrieved 23 potentially relevant papers that were evaluated for methodological quality, of which 11 studies met the inclusion criteria. The main finding was that no profession in the study consistently attained an overall high concordance rating. Of the three professions examined, 73% of chiropractors adhered to current clinical practice guidelines, followed by physiotherapists (62%) and then medical practitioners (52%).
  
  
  CONCLUSIONS
  This review showed that quality papers in this area of research are very limited. Notwithstanding, chiropractors appear to adhere to clinical practice guidelines more so than physiotherapists and medical practitioners, although there is scope for improvement across all three professions.
authors.affiliation: Senior Clinical Supervisor, School of Health Professions [Discipline of Chiropractic], Murdoch University, Enrolled student, Master of Public Health, School of Population Health Faculty of Medicine, Dentistry and Health Sciences The University of Western Australia, Email: L.Woods@murdoch.edu.au , Postal Address: Murdoch University, South Street Campus, 90 South Street, MURDOCH Western Australia 6150, Telephone: +61 8-93601202.
authors.forename: Lyndon G
authors.initials: LG
authors.lastname: Amorin-Woods
authors.affiliation: Senior Clinical Supervisor, School of Health Professions [Discipline of Chiropractic], Murdoch University, Enrolled student, Master of Public Health, School of Population Health Faculty of Medicine, Dentistry and Health Sciences The University of Western Australia, Email: L.Woods@murdoch.edu.au , Postal Address: Murdoch University, South Street Campus, 90 South Street, MURDOCH Western Australia 6150, Telephone: +61 8-93601202.
authors.forename: Randy W
authors.initials: RW
authors.lastname: Beck
authors.affiliation: Registrar in Emergency Medicine, Registered Medical Practitioner, Rockingham General Hospital; Registered Chiropractor.
authors.forename: Gregory F
authors.initials: GF
authors.lastname: Parkin-Smith
authors.affiliation: Senior Research Assistant, Institute of Functional Neuroscience, PERTH, Australia.
authors.forename: James
authors.initials: J
authors.lastname: Lougheed
authors.affiliation: Associate Professor, School of Population Health, Faculty of Medicine and Dentistry and Health Sciences, The University of Western Australia PERTH, Australia Email: Alexandra.Bremner@uwa.edu.au.
authors.forename: Alexandra P
authors.initials: AP
authors.lastname: Bremner
keywords: chiropractic; evidence based guidelines; low back pain; medicine; physiotherapy