Abstract
BackgroundClinical practice guidelines (CPGs) provide conveniently packaged evidence-based recommendations to inform clinical decisions. However, intended end-users often do not know how to source, appraise, interpret or choose among CPGs. Moreover, it can be confusing when recommendations on the same topic differ among CPGs, in wording, intent and underpinning evidence.ObjectivesThis article reports on the processes of: (1) identifying current CPGs for acute and subacute low back pain (LBP) to fit the needs of South African physiotherapists, (2) collating and summarising CPG recommendations to produce a user-friendly end-user product and (3) testing the utility of the summary CPG document on South African physiotherapy clinicians to efficiently determine acceptability, appropriateness and feasibility to inform clinical decision-making.MethodAn adapted approach was followed by systematically searching online CPG repositories and online databases for LBP CPGs; screening and critically appraising identified CPGs; summarising recommendations from relevant CPGs and organising them into clinical practice activities. Feedback on utility was obtained from 11 physiotherapists.ResultsThree high-quality, international CPGs provided 25 recommendations on the assessment and management of acute and subacute LBP relevant to South African physiotherapy practice. They were organised into 10 headings. Physiotherapy user feedback suggested that this document would assist in clinical decision-making.ConclusionOrganised recommendations extracted from multiple, relevant CPGs provide an end-user-friendly resource for physiotherapists treating LBP.Clinical implicationsCollated and organised CPG recommendations may effectively assist South African physiotherapists’ clinical decision-making in assessing and managing patients with acute and subacute LBP.
Highlights
Clinical practice guidelines (CPGs) provide conveniently packaged evidencebased recommendations to inform clinical decisions
This article reports on the processes of: (1) identifying current CPGs for acute and subacute low back pain (LBP) to fit the needs of South African physiotherapists, (2) collating and summarising CPG recommendations to produce a user-friendly end-user product and (3) testing the utility of the summary CPG document on South African physiotherapy clinicians to efficiently determine acceptability, appropriateness and feasibility to inform clinical decision-making
Physiotherapy user feedback suggested that this document would assist in clinical decision-making
Summary
Clinical practice guidelines (CPGs) provide conveniently packaged evidencebased recommendations to inform clinical decisions. Clinical practice guidelines (CPGs) are ‘a convenient way of packaging evidence and presenting recommendations to healthcare decision makers’ A recent systematic review found that both the point and annual prevalence of LBP were higher among African populations compared to global LBP prevalence (Morris et al 2018). This may be attributed to heavy physical work and manual lifting, sustained flexion postures and psychosocial factors (including fear-avoidance beliefs, catastrophising, anxiety and illness perception) (Igwesi-Chidobe et al 2017; Tella et al 2013). Reported barriers to South African physiotherapists’ uptake of CPGs include resource constraints
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