Italian physiotherapists’ knowledge of and adherence to osteoarthritis clinical practice guidelines: a cross-sectional study

BMC Musculoskeletal Disorders

Andrea Dell’Isola¹  Serena Millotti²  Stefano Salvioli²  Marco Testa²  Simone Battista³ 

[1] Clinical Epidemiology Unit, Orthopedics, Department of Clinical Sciences Lund, Lund University, Lund, Sweden;Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Campus of Savona, Genova, Italy;Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Campus of Savona, Genova, Italy;Clinical Epidemiology Unit, Orthopedics, Department of Clinical Sciences Lund, Lund University, Lund, Sweden;

关键词: Osteoarthritis;    Osteoarthritis, knee;    Osteoarthritis, hip;    Practice guidelines as topic;    Clinical governance;    Physical therapy specialty;    Physical therapists;    Education, public health professional;   

DOI  :  10.1186/s12891-021-04250-4

来源: Springer

【 摘 要 】

IntroductionImplementation of clinical practice guidelines (CPGs) to manage musculoskeletal conditions among physiotherapists appears suboptimal. Osteoarthritis is one of the most disabling conditions worldwide and several studies showed a lack of knowledge of and adherence to osteoarthritis CPGs in physiotherapists’ clinical practice. However, those studies are not conclusive, as they examine the knowledge of and adherence to CPGs only in isolation, or only by focussing on a single treatment. Thus, analysis of the knowledge of and adherence to CPGs in the same sample would allow for a better understanding of the evidence-to-practice gap, which, if unaddressed, can lead to suboptimal care for these patients. This study aims at assessing Italian physiotherapists’ evidence-to-practice gap in osteoarthritis CPGs.MethodsAn online survey divided into two sections investigating knowledge of and adherence to CPGs was developed based on three high-quality, recent and relevant CPGs. In the first section, participants had to express their agreement with 24 CPG statements through a 1 (completely disagree) to 5 (completely agree) scale. We defined a ≥ 70% agreement with a statement as consensus. In the second section, participants were shown a clinical case, with different interventions to choose from. Participants were classified as ‘Delivering’ (all recommended interventions selected), ‘Partially Delivering’ (some recommended interventions missing) and ‘Non-Delivering’ (at least one non-recommended interventions selected) the recommended intervention, depending on chosen interventions.Results822 physiotherapists (mean age (SD): 35.8 (13.3); female 47%) completed the survey between June and July 2020. In the first section, consensus was achieved for 13/24 statements. In the second section, 25% of the participants were classified as ‘Delivering’, 22% as ‘Partially Delivering’ and 53% as ‘Non-Delivering’.ConclusionsOur findings revealed an adequate level of knowledge of osteoarthritis CPGs regarding the importance of exercise and education. However, an adequate level of adherence has yet to be reached, since many physiotherapists did not advise weight reduction, but rest from physical activity, and often included secondary treatments (e.g. manual therapy) supported by low-level evidence. These results identify an evidence-to-practice gap, which may lead to non-evidence based practice behaviours for the management of patients with osteoarthritis.

【 授权许可】

CC BY