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Managing low back pain in the primary care setting: the know-do gap.

机译:在基层医疗机构中处理腰痛:知识差距。

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OBJECTIVE: To ascertain knowledge gaps in the diagnosis and treatment of acute and chronic low back pain (LBP) in the primary care setting to prepare a scoping survey for identifying knowledge gaps in LBP management among Alberta's primary care practitioners, and to identify potential barriers to implementing a multidisciplinary LBP guideline. METHODS: English language studies, published from 1996 to 2008, comparing the clinical practice patterns of primary care practitioners with guideline recommendations were identified by systematically searching literature databases, the websites of various health technology assessment agencies and libraries, and the Internet. Data were synthesized qualitatively. RESULTS: The literature search identified 14 relevant studies. Knowledge gaps were reported among various primary care practitioner groups in the assessment of red flags, use of diagnostic imaging, provision of advice regarding sick leave and continuing activity, administration of some medications (muscle relaxants, oral steroids and opioids) and recommendation of particular treatments (acupuncture, physiotherapy, spinal manipulation, traction, ultrasound, transcutaneous electrical nerve stimulation and spinal mobilization). CONCLUSIONS: A know-do gap clearly exists among primary care practitioners with respect to the diagnosis and treatment of LBP. The information on know-do gaps will be used to construct a survey tool for unearthing the local knowledge gaps extant among Alberta's primary care practitioners, and to develop a dissemination strategy for a locally produced multidisciplinary LBP guideline, with the aim of ensuring that the know-do gaps inherent within each primary practice discipline are specifically targeted.
机译:目的:确定初级保健机构在急慢性腰背痛(LBP)的诊断和治疗中的知识差距,以进行范围界定调查,以识别艾伯塔省初级保健从业者中LBP管理方面的知识差距,并找出可能的障碍实施多学科LBP指南。方法:通过系统地搜索文献数据库,各种卫生技术评估机构和图书馆的网站以及互联网,确定了1996年至2008年发表的英语研究,该研究比较了初级保健从业者的临床实践模式与指南建议。数据定性地合成。结果:文献检索确定了14项相关研究。据报告,各基层医疗从业者群体之间在评估红旗,使用诊断成像,提供有关病假和持续活动的建议,某些药物(肌肉松弛剂,口服类固醇和阿片类药物)的使用方面的知识差距。 (针灸,理疗,脊柱操纵,牵引,超声,经皮电神经刺激和脊柱动员)。结论:在初级保健从业者中,关于LBP的诊断和治疗显然存在知识差距。有关知识差距的信息将用于构建调查工具,以发掘艾伯塔省初级保健从业人员中存在的本地知识差距,并为本地制定的多学科LBP指南制定传播策略,以确保了解-针对每个主要实践学科固有的差距。

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