Implementation Initiatives to Improve Low Back Pain Care in Australia: A Scoping Review.

Autor:	Costa N; Faculty of Medicine and Health, The University of Sydney, Sydney School of Public Health, Menzies Centre for Health Policy and Economics, Sydney, New South Wales, Australia.; School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia., Blyth FM; Faculty of Medicine and Health, The University of Sydney, Sydney School of Public Health, Menzies Centre for Health Policy and Economics, Sydney, New South Wales, Australia., Amorim AB; Faculty of Medicine and Health, The University of Sydney, School of Health Sciences, Sydney, New South Wales, Australia., Parambath S; Faculty of Medicine and Health, The University of Sydney, Sydney School of Public Health, Menzies Centre for Health Policy and Economics, Sydney, New South Wales, Australia., Shanmuganathan S; Faculty of Medicine and Health, The University of Sydney, Sydney School of Public Health, Menzies Centre for Health Policy and Economics, Sydney, New South Wales, Australia., Huckel Schneider C; Faculty of Medicine and Health, The University of Sydney, Sydney School of Public Health, Menzies Centre for Health Policy and Economics, Sydney, New South Wales, Australia.
Jazyk:	angličtina
Zdroj:	Pain medicine (Malden, Mass.) [Pain Med] 2022 Dec 01; Vol. 23 (12), pp. 1979-2009.
DOI:	10.1093/pm/pnac102
Abstrakt:	Objective: This scoping review aimed to comprehensively review strategies for implementation of low back pain (LBP) guidelines, policies, and models of care in the Australian health care system. Methods: A literature search was conducted in MEDLINE, EMBASE, CINAHL, Allied and Complementary Medicine Database, and Web of Science to identify studies that aimed to implement or integrate evidence-based interventions or practices to improve LBP care within Australian settings. Results: Twenty-five studies met the inclusion criteria. Most studies targeted primary care settings (n = 13). Other settings included tertiary care (n = 4), community (n = 4), and pharmacies (n = 3). One study targeted both primary and tertiary care settings (n = 1). Only 40% of the included studies reported an underpinning framework, model, or theory. The implementation strategies most frequently used were evaluative and iterative strategies (n = 14, 56%) and train and educate stakeholders (n = 13, 52%), followed by engage consumers (n = 6, 24%), develop stakeholder relationships (n = 4, 16%), change in infrastructure (n = 4, 16%), and support clinicians (n = 3, 12%). The most common implementation outcomes considered were acceptability (n = 11, 44%) and adoption (n = 10, 40%), followed by appropriateness (n = 7, 28%), cost (n = 3, 12%), feasibility (n = 1, 4%), and fidelity (n = 1, 4%). Barriers included time constraints, funding, and teamwork availability. Facilitators included funding and collaboration between stakeholders. Conclusions: Implementation research targeting LBP appears to be a young field, mostly focusing on training and educating stakeholders in primary care. Outcomes on sustainability and penetration of evidence-based interventions are lacking. There is a need for implementation research guided by established frameworks that consider interrelationships between organizational and system contexts beyond the clinician-patient dyad. (© The Author(s) 2022. Published by Oxford University Press on behalf of the American Academy of Pain Medicine.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu