IMPlementing a clinical practice guideline for acute
Low-back pain managEMENT in general practice: the IMPLEMENT
cluster randomised controlled trial [ACTRN012606000098538].
The recently released NHMRC-endorsed
evidence-based clinical practice guideline for acute
low-back pain management provides an opportunity to
assess the effects of a targeted implementation strategy
for use in general medical practice. This trial will
assess the effectiveness and cost-effectiveness of an
implementation strategy both at the general practitioner
and patient level. Successful implementation of these
guidelines will reduce the morbidity and cost of acute
low-back pain. The trial will contribute to our knowledge
about implementation strategies attempting to change
clinical practice behaviour.
The IMPLEMENT project is funded by the
Australian National Health and Medical Research Council.
It is a two stage project with the following aims:
- to identify the barriers and enablers to implementing
an evidence-based clinical practice guideline for
acute low-back pain in general practice using a theoretical
- to develop a targeted implementation strategy to
increase the uptake of the evidence-based clinical
practice guideline which addresses the modifiable
- to test the effectiveness of a strategy for implementing
an evidence based clinical practice guideline for
acute low back pain in a cluster randomised controlled
Stage one consisted of conducting focus
groups with general practitioners (GPs) in Victoria
underpinned by a theoretical framework grounded in behavioural
theory. Multiple barriers to implementing the key messages
of the guideline were identified.
Stage two is now underway, and consists of a cluster randomised controlled trial. Ninety two general practices were recruited and randomised to receive either an active implementation strategy or access to the guideline alone. Outcomes will be assessed at the level of the GP (did practice change?) and the patient (did the change result in improved patient outcomes?). We expect the trial will be completed in December 2008.
Professor Sally Green
Dr Denise O’Connor, Ms Joanne McKenzie, A/Prof
Neil Spike, A/Prof Peter Schattner, Prof Jeremy Grimshaw,
Mr Duncan Mortimer, Mr Simon French, Prof Susan Michie,
Dr Jill Francis, A/Prof Rachelle Buchbinder, Dr Peter
Click here to see all related publications.
firstname.lastname@example.org; phone: 03 9903 0366.