SynthesisPloS one2016
The Influence of Physical Therapy Guideline Adherence on Healthcare Utilization and Costs among Patients with Low Back Pain: A Systematic Review of the Literature.
Synthesis in PloS one, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 42 papers, 1 of them a synthesis 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.
Effects of Patient Education Manual on Pain, Range of Motion and Function in Patient With Chronic Low Back Pain Neck Pain
Effectiveness of Therapeutic Exercise Controlled Through App Adding Face-to-face Supervision Executed by Physical Therapist in the Subacute and Chronic Low Back Pain
Who cites it
42 citing papers in PubMed, 1 synthesis or guideline pooled it, 115 citations in OpenAlex.
- Imaging versus no imaging for low back pain: a systematic review, measuring costs, healthcare utilization and absence from work.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2019Pooled it
- Trial
- Determinants and strategies for implementing guideline-adherent physiotherapy: a scoping review.BMJ open · 2026Article
- Prognostic Factors of High Healthcare Utilization Costs Among People With Spinal Disorders Using a Spine Registry Linked to Public Healthcare Data.European journal of pain (London, England) · 2026Article
- Can a tailored implementation programme enhance the adoption of guideline-adherent behaviour in physiotherapists and chiropractors managing patients with low back pain? An implementation study.Implementation science communications · 2025Article
- Retrospective Case-Control Study on the Effect of In-Person Physical Therapy With Remote Therapeutic Monitoring on Functional Outcomes and Plan of Care Adherence Amongst Individuals With Musculoskeletal Conditions.Archives of rehabilitation research and clinical translation · 2025Article
- Measuring guideline adherence in physiotherapy: A scoping review of methodological approaches.Journal of evaluation in clinical practice · 2025Article
- Article
- Adherence to neck and low back pain clinical practice guidelines based on clinical specialization: a survey of physical therapists.The Journal of manual & manipulative therapy · 2025Article
- Determinants of Appointment Planning in Physical Therapy: Insights from Saudi Arabia.Healthcare (Basel, Switzerland) · 2025Article
- Article
- A critical review of the role of manual therapy in the treatment of individuals with low back pain.The Journal of manual & manipulative therapy · 2024Review
- Influence and Relationship of Pain on Lumbar Biomechanics in a Young Adult Population with Non-Specific Low Back Pain.Sports (Basel, Switzerland) · 2024Article
- Low back pain management in primary healthcare: findings from a scoping review on models of care.BMJ open · 2024Article
- Developing a low back pain guideline implementation programme in collaboration with physiotherapists and chiropractors using the Behaviour Change Wheel: a theory-driven design study.Implementation science communications · 2024Article
- Financial impact associated with implementation of the low back pain clinical practice guideline in outpatient physical therapist practice at a large academic medical center.Physiotherapy theory and practice · 2024Article
- Clinician approaches to new spine pain cases in primary care: Balance of opioid prescribing and early linkage to exercise therapy and spinal manipulation.Journal of evaluation in clinical practice · 2024Article
- Guideline adherent screening and referral: do third year Doctor of Physical Therapy students identify red and yellow flags within descriptive patient cases? a United States based survey study.The Journal of manual & manipulative therapy · 2023Article
- Barriers, facilitators and implementation strategies for guideline-adherence in physiotherapy: a scoping review protocol.BMJ open · 2023Article
- Factors associated with referral to physiotherapists for adult patients consulting for musculoskeletal disorders in primary care; an ancillary study to ECOGEN.BMC primary care · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLow back pain (LBP) is common and associated healthcare costs are significant. While clinical practice guidelines have been established in an attempt to reduce costs and healthcare utilization, it is unclear if adherence to physical therapy guidelines for those with LBP is efficacious. Therefore, the purpose of this study was to assess current evidence and evaluate the impact of physical therapy guideline adherence on subsequent healthcare costs and utilization for patients with LBP.
methodsAn electronic search was conducted in PubMed, CINAHL (EBSCO Host), AMED (Ovid), and PEDro. Studies included in this review were published in peer reviewed journals and the primary mode of treatment was administered by a physical therapist. Also, the definition of adherence was clearly defined based on claims data and at least one measure of cost or utilization reported. Quality assessment was evaluated via a modified Downs and Black checklist. Due to the conceptual heterogeneity in variable measurements, data were qualitatively synthesized and stratified by reported utilization and cost measures.
resultsA total of 256 results were identified and after omitting duplicates, 4 articles were retained, which were all retrospective in nature. Quality scores ranged between 19 and 21 points out of a possible 26 on the modified Downs and Black checklist. All identified studies used the same definition of guideline adherence, which focused on billing active codes and minimizing use of passive codes. The results demonstrated trends that, with a few exceptions, suggested those patients with LBP that were treated with an adherent guideline program demonstrated decreased healthcare utilization and an overall healthcare savings.
conclusionPreliminary evidence suggests that adherence to established clinical practice guidelines may assist with decreasing healthcare utilization and costs. Additional research based on prospective randomized controlled trials are needed to provide high quality evidence regarding the impact of guideline adherence among patients with LBP.
Indexed as
Identifiers
What 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.