Evidence Demands Compliance in Care of Acute Low Back PainPatients with acute low back pain (LBP) can and often do receive a wide range of medical treatment for the same back problem. To help standardize treatment, the military healthcare system (MHS) developed clinical practice guidelines (CPGs) for LBP. The goal of CPGs is to improve quality of care and outcomes after treatment.
This study looks at two things related to CPGs for LBP. First, do doctors use the CPGs? Second, how do the results compare between patients treated according to the CPGs and those who aren't treated using CPGs?
With more than nine million members of the MHS, the authors had a large sample for this study. The patients came from a computerized database of patient care records kept by the Department of Defense.
Results of treatment were measured using patient satisfaction, general health, and function. The cost of care was also calculated for each patient. The authors report less than half of the patients (42 per cent) received care for their acute LBP according to the established CPGs.
Younger patients on active duty and in good health were most likely to receive CPG care. Patients receiving CPG care had higher levels of satisfaction and function. The cost of their care was also much lower ($222.00 versus $712.00).
The authors think the evidence-based CPGs aren't used as they should be. This may be because healthcare providers expect that most patients with LBP will get better without treatment. Doctors may think there are many steps in the CPGs that may not be needed so they don't use them at all.
The results of this study clearly show that following CPGs for acute LBP is linked with improved outcomes. More efforts should be made to educate health care professionals treating patients with LBP to use these guidelines. Patient costs would be less and there would be better results and greater patient satisfaction.
Michael Feuerstein, et al. Evidence-based Practice for Acute Low Back Pain in Primary Care: Patient Outcomes and Cost of Care. In Pain. September 2006. Vol. 124. Pp. 140-149.
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