Trial reportBMC health services research2018
Effectiveness of a multifaceted implementation strategy compared to usual care on low back pain guideline adherence among general practitioners.
Trial report in BMC health services research, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 2 of them syntheses that pooled it.
What it found
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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
24 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Models of care for managing non-specific low back pain.The Cochrane database of systematic reviews · 2025Pooled it
- Defining and measuring imaging appropriateness in low back pain studies: a scoping review.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 · 2020Pooled it
- Trial
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- Data Resource Profile: The General Practice Database-Amsterdam, North Holland, Almere (GPD-ANHA).International journal of epidemiology · 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
- 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
- Article
- Effectiveness of strategies for implementing guideline-concordant care in low back pain: a systematic review and meta-analysis of randomised controlled trials.EClinicalMedicine · 2024Article
- eHealth-Integrated Psychosocial and Physical Interventions for Chronic Pain in Older Adults: Scoping Review.Journal of medical Internet research · 2024Article
- Is the use of diagnostic imaging and the self-reported clinical management of low back pain patients influenced by the attitudes and beliefs of chiropractors? A survey of chiropractors in the Netherlands and Belgium.Chiropractic & manual therapies · 2024Article
- Quality Indicators for Pediatric Bronchiolitis and Croup Care in the Emergency Department; a Systematic Review and Meta-Analysis.Archives of academic emergency medicine · 2024Review
- Trends in guideline implementation: an updated scoping review.Implementation science : IS · 2022Article
- Evaluation of a guidelines implementation intervention to reduce work disability and sick leaves related to chronic musculoskeletal pain: a theory-informed qualitative study in occupational health care.BMC musculoskeletal disorders · 2022Article
- Effect of a multimedia training programme for pain management on pain intensity and depression in patients with non-specific chronic back pain.Investigacion y educacion en enfermeria · 2022Article
- Clinician education unlikely effective for guideline-adherent medication prescription in low back pain: systematic review and meta-analysis of RCTs.EClinicalMedicine · 2022Article
- What behaviour change techniques have been used to improve adherence to evidence-based low back pain imaging?Implementation science : IS · 2021Review
- Impact on radiological practice of active guideline implementation of musculoskeletal guideline, as measured over a 12-month period.Acta radiologica open · 2021Article
- Involving practice nurse and other assistant clinical staff members in the management of low back pain: A qualitative interview study from Danish general practice.SAGE open medicine · 2021Article
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.
Funding
Abstract
backgroundTo improve patient care, and to reduce unnecessary referrals for diagnostic imaging and medical specialist care for low back pain, an evidence-based guideline for low back pain was developed in the Netherlands in 2010. The current study evaluated the effect of a multifaceted implementation strategy on guideline adherence among Dutch general practitioners.
methodsThe implementation strategy included a multidisciplinary training, provision of educational material and an interactive website for healthcare professionals, supported by a multimedia eHealth intervention for patients with low back pain. Adherence was measured using performance indicators based on 3 months data extracted from the contacts with patients with low back pain recorded in the electronic medical records of participating general practitioners. Performance indicators were compared between two groups: a usual care group and an implementation group. Performance indicators were referrals to consultations with medical specialists, to diagnostic imaging, and to psychosocial and/or occupational physician consultations, and inquiries about psychosocial and occupational risk factors.
resultsThe electronic medical records of 5130 patient contacts for LBP were analysed; 2453 patient contacts in the usual care group and 2677 patient contacts in the implementation group. Overall, rates of referral and of recorded inquiries regarding psychosocial and occupational risk factors remained low in both groups over time. The only statistically significant difference found was a reduction in the number of referrals to neurologists in the implementation group (from 100 (7%) to 50 (4%)) compared to the usual care group (from 48 (4%) to 50 (4%), (p < 0.01)). There were no other between-group differences in referrals.
conclusionIn the short term, the strategy did not result in improved guideline adherence among general practitioners, and it is not recommended for widespread use. However, baseline referral rates in participating practices were already low, possibly leaving only little room for improvement. Inquiries for psychosocial and occupational risk factors remained low and this leaves room for improvement.
trial registrationThis trial is registered in the Netherlands Trial Register (NTR): NTR4329 . Registration date: December 20th, 2013.
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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.