Clinical guidelines for the management of low back pain in primary care - An international comparison

被引:486
作者
Koes, BW
van Tulder, MW
Ostelo, R
Burton, AK
Waddell, G
机构
[1] Erasmus Univ, Dept Gen Practice, NL-3000 DR Rotterdam, Netherlands
[2] Inst Res Extramural Med, Amsterdam, Netherlands
[3] Maastricht Univ, Dept Epidemiol, Maastricht, Netherlands
[4] Univ Huddersfield, Spinal Res Unit, Huddersfield HD1 3DH, W Yorkshire, England
[5] Glasgow Nuffield Hosp, Glasgow, Lanark, Scotland
关键词
clinical guidelines; low back pain; evidence based medicine; systematic reviews;
D O I
10.1097/00007632-200111150-00022
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Study Design. Descriptive study. Objectives. To compare national clinical guidelines on low back pain. Summary of Background Data. To rationalize the management of low back pain, clinical guidelines have been issued in various countries around the world. Given that the available scientific evidence is the same, irrespective of the country, one would expect these guidelines to include more or less similar recommendations regarding diagnosis and treatment. Methods. Guidelines were included that met the following criteria: the target group consisted of primary care health professionals, and the guideline was published in English, German, or Dutch. Only one guideline per country was included: the one most recently published. Results. Clinical guidelines from 11 different countries published from 1994 until 2000 were included in this review. The content of the guidelines appeared to be quite similar regarding the diagnostic classification (diagnostic triage) and the use of diagnostic and therapeutic interventions, Consistent features were the early and gradual activation of patients, the discouragement of prescribed bed rest, and the recognition of psychosocial factors as risk factors for chronicity. However, there were discrepancies for recommendations regarding exercise therapy, spinal manipulation, muscle relaxants, and patient information. Conclusion. The comparison of clinical guidelines for the management of low back pain showed that diagnostic and therapeutic recommendations were generally similar. Updates of the guidelines are planned in most countries, although so far produced only in the United Kingdom. However, new evidence may lead to stronger conclusions and enable future guidelines to become even more concordant.
引用
收藏
页码:2504 / 2513
页数:10
相关论文
共 40 条
[1]   The role of activity in the therapeutic management of back pain - Report of the International Paris Task Force on Back Pain [J].
Abenhaim, L ;
Rossignol, M ;
Valat, JP ;
Nordin, M ;
Avouac, B ;
Blotman, F ;
Charlot, J ;
Dreiser, RL ;
Legrand, E ;
Rozenberg, S ;
Vautravers, P .
SPINE, 2000, 25 (04) :1S-33S
[2]  
*ACC NAT HLTH COMM, 1997, NZ AC LOW BACK PAIN
[3]  
[Anonymous], HUISARTS WET
[4]  
[Anonymous], KREUZSCHMERZEN HINTE
[5]  
Bigos S., 1994, Clinical practice guideline
[6]  
BOGDUK N, 2000, DRAFT EVIDENCE BASED
[7]  
Borkan Jeffrey, 1996, Harefuah, V130, P145
[8]  
Burton AK, 1998, BAILLIERE CLIN RHEUM, V12, P17
[9]  
Carter JT, 2000, OCCUPATIONAL HLTH GU
[10]  
*CENTR BEG INT TOE, 1995, CONS LUMB RAD SYNDR