@article{18253,
  keywords = {Peer Reviewed Paper, Checked},
  author = {Refshauge K. and Rebbeck T. and Maher C.},
  title = {Evaluating two implementation strategies for whiplash guidelines in physiotherapy: a cluster-randomised trial},
  abstract = {<p>
QUESTION: Are implementation strategies involving education any more effective than mere dissemination of clinical practice guidelines in changing physiotherapy practice and reducing patient disability after acute whiplash? DESIGN: Cluster-randomised trial. PARTICIPANTS: Twenty-seven physiotherapists from different private physiotherapy clinics and the 103 patients (4 dropouts) who presented to them with acute whiplash. INTERVENTION: The implementation group of physiotherapists underwent education by opinion leaders about whiplash guidelines and the dissemination group had the guidelines mailed to them. OUTCOME MEASURES: The primary outcome was patient disability, measured using the Functional Rating Index, collected on admission to the trial and at 1.5, 3, 6 and 12 months. Physiotherapist knowledge about the guidelines was measured using a custom-made questionnaire. Physiotherapist practice and cost of care were measured by audit of patient notes. RESULTS: There were no significant differences between groups for any of the patient outcomes at any time. The implementation patients had 0.6 points (95% CI -7.8 to 6.6) less disability than the dissemination patients at 12 months; 44% more physiotherapists in the implementation group reported that they prescribed two out of the five guideline-recommended treatments; and 32% more physiotherapists actually prescribed them. The cost of care for patients in the implementation group was $255 (95% CI -1505 to 996) less than for patients in the dissemination group. CONCLUSION: Although the active implementation program increased guideline-consistent practice, patient outcomes and cost of care were not affected.
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},
  year = {2006},
  journal = {Australian Journal of Physiotherapy},
  volume = {52},
  chapter = {1.870},
  number = {3},
  pages = {165-174. [Impact Factor 1.870]},
  note = {HERDC category C1},
  language = {eng},
}