Trial reportThe British journal of general practice : the journal of the Royal College of General Practitioners2004
Implementation of RCGP guidelines for acute low back pain: a cluster randomised controlled trial.
Trial report in The British journal of general practice : the journal of the Royal College of General Practitioners, 2004. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers, 12 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
44 citing papers in PubMed, 12 syntheses or guidelines pooled it, 85 citations in OpenAlex.
- Models of care for managing non-specific low back pain.The Cochrane database of systematic reviews · 2025Pooled it
- Strategies to reduce the use of low-value medical tests in primary care: a systematic review.The British journal of general practice : the journal of the Royal College of General Practitioners · 2020Pooled it
- Nudge strategies to improve healthcare providers' implementation of evidence-based guidelines, policies and practices: a systematic review of trials included within Cochrane systematic reviews.Implementation science : IS · 2020Pooled it
- Physician-reported barriers to using evidence-based recommendations for low back pain in clinical practice: a systematic review and synthesis of qualitative studies using the Theoretical Domains Framework.Implementation science : IS · 2019Pooled it
- Effectiveness of multifaceted implementation strategies for the implementation of back and neck pain guidelines in health care: a systematic review.Implementation science : IS · 2016Pooled it
- Implementation interventions to improve the management of non-specific low back pain: a systematic review.BMC musculoskeletal disorders · 2016Pooled it
- Professional interventions for general practitioners on the management of musculoskeletal conditions.The Cochrane database of systematic reviews · 2016Pooled it
- Effectiveness of interventions designed to reduce the use of imaging for low-back pain: a systematic review.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2015Pooled it
- Referral interventions from primary to specialist care: a systematic review of international evidence.The British journal of general practice : the journal of the Royal College of General Practitioners · 2014Pooled it
- Interventions for improving the appropriate use of imaging in people with musculoskeletal conditions.The Cochrane database of systematic reviews · 2010Pooled it
- Content and outcome of usual primary care for back pain: a systematic review.The British journal of general practice : the journal of the Royal College of General Practitioners · 2008Pooled it
- Educational outreach visits: effects on professional practice and health care outcomes.The Cochrane database of systematic reviews · 2007Pooled it
- A multifaceted implementation strategy versus passive implementation of low back pain guidelines in general practice: a cluster randomised controlled trial.Implementation science : IS · 2016Trial
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- IMPaCT Back study protocol. Implementation of subgrouping for targeted treatment systems for low back pain patients in primary care: a prospective population-based sequential comparison.BMC musculoskeletal disorders · 2010Trial
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- Testing the effectiveness of an innovative information package on practitioner reported behaviour and beliefs: the UK Chiropractors, Osteopaths and Musculoskeletal Physiotherapists Low back pain ManagemENT (COMPLeMENT) trial [ISRCTN77245761].BMC musculoskeletal disorders · 2005Trial
- Effectiveness of strategies for implementing guideline-concordant care in low back pain: a systematic review and meta-analysis of randomised controlled trials.EClinicalMedicine · 2025Article
- Dissemination Strategies for Clinical Practice Guidelines Focused on Imaging for Low Back Pain: A Scoping Review.Musculoskeletal care · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe Royal College of General Practitioners (RCGP) has produced guidelines for the management of acute low back pain in primary care.
aimTo investigate the impact on patient management of an educational strategy to promote these guidelines among general practitioners (GPs). DESIGN OF STUDY: Group randomised controlled trial, using the health centre as the unit of randomisation.
settingPrimary care teams in north-west England.
methodTwenty-four health centres were randomly allocated to an intervention or control arm. Practices in the intervention arm were offered outreach visits to promote national guidelines on acute low back pain, as well as access to fast-track physiotherapy and to a triage service for patients with persistent symptoms.
resultsTwenty-four centres were randomised. Two thousand, one hundred and eighty-seven eligible patients presented with acute low back pain during the study period: 1049 in the intervention group and 1138 in the control group. There were no significant differences between study groups in the proportion of patients who were referred for X-ray, issued with a sickness certificate, prescribed opioids or muscle relaxants, or who were referred to secondary care, but significantly more patients in the intervention group were referred to physiotherapy or the back pain unit (difference in proportion = 12.2%, 95% confidence interval [CI] = 2.8% to 21.6%).
conclusionThe management of patients presenting with low back pain to primary care was mostly unchanged by an outreach educational strategy to promote greater adherence to RCGP guidelines among GPs. An increase in referral to physiotherapy or educational programmes followed the provision of a triage service.
Indexed as
Identifiers
14965404PMC1314775W2115099177What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.