| Autor: |
Daniel L Belavy, Scott D Tagliaferri, Paul Buntine, Tobias Saueressig, Kate Sadler, Christy Ko, Clint T Miller, Patrick J Owen |
| Jazyk: |
angličtina |
| Rok vydání: |
2022 |
| Předmět: |
|
| Zdroj: |
EClinicalMedicine, Vol 43, Iss , Pp 101193- (2022) |
| Druh dokumentu: |
article |
| ISSN: |
2589-5370 |
| DOI: |
10.1016/j.eclinm.2021.101193 |
| Popis: |
Summary: Background: Effectiveness of implementing interventions to optimise guideline-recommended medical prescription in low back pain is not well established. Methods: A systematic review and random-effects meta-analyses for dichotomous outcomes with a Paule-Mandel estimator. Five databases and reference lists were searched from inception to 4th August 2021. Randomised controlled/clinical trials in adults with low back pain to optimise medication prescription were included. Cochrane Risk of Bias 2 tool and GRADE were implemented. The review was registered prospectively with PROSPERO (CRD42020219767). Findings: Of 3352 unique records identified in the search, seven studies were included and five were eligible for meta-analysis (N=11339 participants). Six of seven studies incorporated clinician education, three studies included audit/feedback components and one study implemented changes in medical records systems. Via meta-analysis, we estimated a non-significant odds-ratio of 0·94 (95% CI (0·77; 1.16), I² = 0%; n=5 studies, GRADE: low) in favour of the intervention group. The main finding was robust to sensitivity analyses. Interpretation: There is low quality evidence that existing interventions to optimise medication prescription or usage in back pain had no impact. Peer-to-peer education alone does not appear to lead to behaviour change. Organisational and policy interventions may be more effective. Funding: This work was supported by internal institutional funding only. |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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