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遵循临床实践指南对腰痛患者疼痛和残疾结局的影响——一项严格评价的主题

The Effect of Following Clinical Practice Guidelines on the Pain and Disability Outcomes of Patients With Low Back Pain-A Critically Appraised Topic.

作者信息

Golec Sara J, Valier Alison R

出版信息

J Sport Rehabil. 2018 Mar 1;27(2):189-193. doi: 10.1123/jsr.2015-0185. Epub 2018 Mar 8.

Abstract

UNLABELLED

Clinical Scenario: Health care clinicians are encouraged to practice according to the best available evidence for the purpose of improving patient outcomes. Clinical practice guidelines are one form of evidence that has been developed to enhance the care that patients receive for particular conditions. Low back pain is a common condition in rehabilitation medicine that places a significant financial burden on the healthcare system. Patients with low back pain often suffer great pain and disability that can last a long time, making effective and efficient care a priority. Several guidelines for the treatment of low back pain have been created; however, there is no consensus on whether following these guidelines will positively reduce the pain and disability experienced by patients.

CLINICAL QUESTION

Does adherence to clinical practice guidelines for patients with nonspecific low back pain reduce pain and disability? Summary of Key Findings: A total of 4 studies of level 3 or higher were found. Four studies noted an improvement in disability following guidelines adherent care. Two studies reported greater reduction in pain with guideline adherent care and 2 did not.  Clinical Bottom Line: Moderate evidence exists to support adherence to clinical practice guidelines to improve pain and disability ratings in patients with nonspecific low back pain.

摘要

未标注

临床案例:鼓励医疗保健临床医生依据最佳可得证据进行实践,以改善患者治疗效果。临床实践指南是为提高患者针对特定病症所接受的护理而制定的一种证据形式。腰痛是康复医学中的常见病症,给医疗保健系统带来了巨大的经济负担。腰痛患者常常遭受剧痛和长期残疾,因此有效且高效的护理成为当务之急。已经制定了多项腰痛治疗指南;然而,对于遵循这些指南是否会切实减轻患者的疼痛和残疾,尚无共识。

临床问题

遵循非特异性腰痛患者的临床实践指南是否能减轻疼痛和残疾?关键发现总结:共找到4项3级或更高等级的研究。4项研究指出,遵循指南护理后残疾情况有所改善。2项研究报告称,遵循指南护理能更大程度地减轻疼痛,另外2项则未发现此效果。临床结论:有中等证据支持遵循临床实践指南可改善非特异性腰痛患者的疼痛和残疾评级。

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