Adherence to low back pain clinical practice guidelines by Saudi physical therapists: a cross-sectional study

Abstract

Background: Clinical practice guidelines (CPG) have been developed to assist physical therapists (PTs) in managing individuals with low back pain (LBP). Early adherence to the recommendations of CPG for LBP may improve quality of care, lessen the number of hospital visits, and enhance treatment outcomes. Objective: To examine: 1) Saudi PTs’ adherence to CPG for LBP; and 2) their ability to recognize red and yellow flags. Methods: This was a cross-sectional study. We approached 583 Saudi PTs who are licensed to work in Saudi Arabia, and involved in managing patients with LBP. Data were collected through an electronic survey; it consisted of 6 clinical vignettes presenting patients with LBP. Each vignette was followed by 25 treatment options. The PTs were allowed to select up to 5 treatment options needed during the first week of treatment. Results: A total of 133 PTs completed the survey. PTs overall adherence ranged from 5.3% to 57.4%. The highest adherence rate was for LBP associated with red flags, which ranged between 29.1%, and 57.4%. The lowest adherence rate was for acute LBP with mobility deficit (5.3%). Logistic regression showed that adherence rates are independent from factors such as, years of experience, caseload, and highest degree attained. Conclusion: The study showed an overall low adherence to the CPG. Adherence was best when LBP is associated with red flags. Education and training programs may be needed to improve PTs’ adherence to CPG for LBP.