Lemieux J, Kawchuk G, Kongsted A, Hartvigsen J, Abdollah V, Jones A
Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada.
Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.
Pilot Feasibility Stud. 2021 Feb 1;7(1):38. doi: 10.1186/s40814-020-00758-z.
Evidenced-based clinical guidelines for the treatment of low back pain (LBP) consistently suggest educating patients about their back pain, its natural course, and providing advice to keep active and continue working. Despite this evidence, clinicians routinely do not follow these recommendations resulting in ineffective and fragmented care. GLA:D® Back, a standardized care package, was originally developed in Denmark to assist clinicians in implementing evidence-based care. This study will evaluate the feasibility of implementing the English version of the Danish GLA:D® Back program in Alberta, Canada.
Thirty-five clinicians from nineteen clinics in Alberta, Canada, participated. Feasibility of program implementation, our primary objective, was evaluated within 3 months. Feasibility success was defined as 50% clinician/clinic adoption in addition to 66-88 enrolled participants registered in the database. Our secondary objectives included collecting data pertaining to clinician confidence, attitudes and behaviour of treating patients, perceived barriers and facilitators of program in addition to collecting patient-data regarding pain, function, general health and self-efficacy.
The majority of the clinics (15/19, 79%) offered GLA:D® Back to their patients within the study period. Of the participating clinicians, GLA:D® Back was delivered by (25/35, 71%) of clinicians. In total, 78 patients were enrolled in the program and (69/78, 88%) participants attended the final assessment. Secondarily, clinicians demonstrated a biomedical and behavioural orientation along with high confidence when treating LBP patients while patient outcomes trended toward improvement.
The English translation of the Danish GLA:D Back program was feasible for Albertan clinicians to implement into practice in both urban and rural settings.
基于证据的腰痛（LBP）治疗临床指南一直建议对患者进行腰痛教育、介绍其自然病程，并提供保持活动和继续工作的建议。尽管有这些证据，但临床医生通常不遵循这些建议，导致护理无效且零散。GLA:D® Back是一个标准化的护理包，最初在丹麦开发，以协助临床医生实施循证护理。本研究将评估在加拿大艾伯塔省实施丹麦GLA:D® Back项目英文版的可行性。
来自加拿大艾伯塔省19家诊所的35名临床医生参与了研究。在3个月内评估项目实施的可行性，这是我们的主要目标。可行性成功的定义是50%的临床医生/诊所采用该项目，此外数据库中有66 - 88名登记参与者。我们的次要目标包括收集与临床医生信心、治疗患者的态度和行为、该项目的感知障碍和促进因素相关的数据，以及收集患者关于疼痛、功能、总体健康和自我效能的数据。
在研究期间，大多数诊所（15/19，79%）向患者提供了GLA:D® Back。在参与的临床医生中，（25/35，71%）的临床医生提供了GLA:D® Back。总共有78名患者登记参加该项目，（69/78，88%）的参与者参加了最终评估。其次，临床医生在治疗LBP患者时表现出生物医学和行为导向以及高度信心，而患者的治疗结果呈改善趋势。
丹麦GLA:D Back项目的英文翻译对于艾伯塔省的临床医生在城市和农村环境中实施到实践中是可行的。
