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050 Developing Evidence-Based Clinical Practice Guidelines for Primary Care Physiotherapy: A Local Initiative
  1. S Bernhardsson1,
  2. M Larsson1,2
  1. 1Region Västra Götaland, Primary Care, Gothenburg, Sweden
  2. 2Sahlgrenska Academy at Gothenburg University, Institute of Neuroscience and Physiology, Gothenburg, Sweden


Background In primary care physiotherapy in Sweden, there is a lack of evidence-based clinical practice guidelines to support clinicians and patients in clinical decision making. A local initiative to develop and implement evidence-based clinical practice guidelines for PTs in primary care was initiated by a regional health authority.

Objectives To develop evidence-based clinical practice guidelines for physiotherapy treatment of low back pain, neck pain, and subacromial pain, for use in primary care physiotherapy in Sweden.

Methods The guideline development was performed by a project team of five primary care physiotherapists in a systematic process that was guided by a 7-step guideline development model by Grol et al. We performed systematic database searches, critical appraisal of the evidence base using GRADE, and formulated evidence-based practice recommendations.

Results The guideline format follows recommendations from AGREE II. The guidelines consist of a brief summary on the first page; a brief introduction to the topic with up-to-date information on definition of the condition, prevalence and prognosis; recommendations on patient management according to strength of evidence; a discussion section, and a detailed reference list. Detailed search strategy and search results, summaries of the body of evidence, recommended outcome measures, and patient information were provided in appendices to the guidelines.

Discussion Rigorous guideline development methodology was considered important to get clinicians’ attention and approval - a requisite for regular use. Clinicians welcomed the initiative.

Implications for Guideline Developers It is important for clinician acceptance that guidelines are brief, to the point and relevant.

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