Measuring guideline adherence in physiotherapy: A scoping review of methodological approaches.

IF 2.1 4区医学 Q3 HEALTH CARE SCIENCES & SERVICES

Journal of evaluation in clinical practice Pub Date : 2024-10-27 DOI:10.1111/jep.14218

Carolin Bahns, Bettina Scheffler, Alexander Bremer, Christian Kopkow

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引用次数: 0

Abstract

Rationale: Clinical practice guidelines summarise the existing evidence on specific health conditions and aim to optimise quality of care by providing evidence-based recommendations. Studies have reported a gap between research findings and clinical practice in physiotherapy. Guideline adherence is often used as a measure of agreement between therapeutic care and guideline recommendations. However, there is currently no standardised methodological approach for measuring guideline adherence.

Aims and objective: The objective of this scoping review was to summarise the methods and results of studies that assessed guideline adherence in physiotherapy.

Methods: MEDLINE, EMBASE, PEDro and CENTRAL databases were searched for relevant literature up to December 2022. Published reports of observational studies and controlled clinical trials that provided information on the assessment of guideline adherence in physiotherapists were included. The selection process was performed independently by two reviewers. The methodological quality of the identified reports was not assessed. Results were summarised narratively.

Results: From a total of 2560 potentially relevant records, 53 reports were included in the analysis. Physiotherapists' adherence to guidelines was primarily assessed in the context of musculoskeletal conditions, such as low back pain (n = 25, 47.2%) and osteoarthritis (n = 8, 15.1%). A wide range of measurement approaches were used with the majority of reports using web-based surveys (n = 21, 39.6%), followed by chart reviews (n = 17, 32.1%). Most reports (n = 21, 39.6%) provided information on the level of adherence in terms of frequency dichotomising (self-reported) clinical practice as adherent or non-adherent. Adherence rates varied widely between included reports.

Conclusions: Although the large number of included reports indicates a high level of interest in the topic of guideline adherence, there is considerable heterogeneity between studies regarding the methodological approaches used to assess guideline adherence in physiotherapists. This reduces the comparability of the study results.

Trial registration: INPLASY (registration no. 202250081). Registered on 12th May 2022.

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衡量物理治疗指南的遵守情况：方法学方法的范围综述。

依据：临床实践指南总结了有关特定健康状况的现有证据，旨在通过提供以证据为基础的建议来优化护理质量。有研究报告称，物理治疗的研究成果与临床实践之间存在差距。指南的依从性通常被用来衡量治疗护理与指南建议之间的一致性。然而，目前还没有衡量指南依从性的标准化方法：本范围综述旨在总结评估物理治疗指南依从性的研究方法和结果：方法：检索了 MEDLINE、EMBASE、PEDro 和 CENTRAL 数据库中截至 2022 年 12 月的相关文献。纳入了已发表的观察性研究和对照临床试验报告，这些报告提供了物理治疗师对指南依从性的评估信息。筛选过程由两名审稿人独立完成。未对已确定报告的方法学质量进行评估。对结果进行了叙述性总结：在总共 2560 份潜在相关记录中，有 53 份报告被纳入分析。物理治疗师对指南的遵守情况主要针对肌肉骨骼疾病进行评估，如腰背痛（n = 25，47.2%）和骨关节炎（n = 8，15.1%）。使用的测量方法多种多样，大多数报告使用了网络调查（21 份，占 39.6%），其次是病历审查（17 份，占 32.1%）。大多数报告（21 份，占 39.6%）都提供了临床实践中坚持或不坚持的频率信息。不同报告的依从率差异很大：尽管纳入的报告数量众多，表明人们对指南依从性这一主题的关注度很高，但不同研究在评估物理治疗师的指南依从性时所采用的方法存在很大差异。这降低了研究结果的可比性：INPLASY（注册号：202250081）。注册日期：2022 年 5 月 12 日。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of evaluation in clinical practice 医学-卫生保健

CiteScore

4.80

自引率

4.20%

发文量

143

审稿时长

3-8 weeks

期刊介绍： The Journal of Evaluation in Clinical Practice aims to promote the evaluation and development of clinical practice across medicine, nursing and the allied health professions. All aspects of health services research and public health policy analysis and debate are of interest to the Journal whether studied from a population-based or individual patient-centred perspective. Of particular interest to the Journal are submissions on all aspects of clinical effectiveness and efficiency including evidence-based medicine, clinical practice guidelines, clinical decision making, clinical services organisation, implementation and delivery, health economic evaluation, health process and outcome measurement and new or improved methods (conceptual and statistical) for systematic inquiry into clinical practice. Papers may take a classical quantitative or qualitative approach to investigation (or may utilise both techniques) or may take the form of learned essays, structured/systematic reviews and critiques.