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The recommendations for the management of chronic low back pain management in primary care keeping in view the high-quality and up-to-date clinical practice guidelines have been reviewed in this study.
Concerning the procedural quality of clinical
practice guidelines, partial progress was noted. Among lately published/revised
clinical guidelines for chronic low back pain management in primary medical
care, only a few were believed to have high-quality evidence.
The recommendations for the management of
chronic low back pain management in primary care keeping in view the
high-quality and up-to-date clinical practice guidelines have been reviewed in
this study.
Database search included exploring the PubMed,
EMBASE, PEDro, Google Scholar, CINHAL, Government and Scientific Association
websites. Three investigators screened the documents as per the inclusion
criteria. The retrieved documents were reviewed via Appraisal of Guidelines,
Research and Evaluation (AGREE) instrument.
Ten
Clinical practice Guidelines fulfilled the inclusion criteria out of 3055
records. These guidelines had moderately variable quality. Four clinical
practice guidelines were regarded as "excellent" and then they were
extracted and briefed. Due to incomplete indexing or publication bias, some
practice guidelines may be absent. As noted, physicians should be aware that
among the recently published/updated guidelines, only a few were found to have
high quality.
Increasing evidence recommends the efficacy of self-management for improving
low back pain outcomes. Physical therapies are suggested for better low back
pain outcomes while many physical modalities like laser therapy, transcutaneous
electrical nerve stimulation, and ultrasound are not suggested. Psychological
therapies are suggested and should be incorporated as part of a broader
therapeutic plan.
Various AGREE II domains portrayed low scores. Especially the "applicability" and "monitoring and auditing criteria" were the most vulnerable domains to alterations in the future.
Disability and Rehabilitation
Evidence for managing chronic low back pain in primary care: a review of recommendations from high-quality clinical practice guidelines
Roberto Meroni et al.
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