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Comment on "Low Back Pain and Best Practice Care"

Michael D. Cabana, MD, MPH

Arch Intern Med. 2010;170(3):277-278.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Despite good intentions, patients do not always follow "doctor's orders." It turns out that physicians are not much better, at least when it comes to adherence to clinical practice guidelines.

Williams and coauthors present another compelling example. They analyzed 3533 patient visits to Australian general practitioners during the 3 years before and the 3 years after the publication of a clinical practice guideline for the treatment of low back pain.¹ The introduction of a local, evidence-based clinical practice guideline had no effect on physician treatment of low back pain as measured by the frequency of patient counseling, prescription of analgesics, and use of imaging.

These results are not an isolated finding. Less-than-optimal rates of physician adherence to back pain guidelines have been noted in the United States, Sweden, and Ireland.^2-4 A systematic review of physician guideline adherence published a decade ago found that no specialty, . . . [Full Text of this Article]

AUTHOR INFORMATION
Author Affiliation: Division of General Pediatrics, University of California, San Francisco, School of Medicine.

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RELATED ARTICLE

Low Back Pain and Best Practice Care: A Survey of General Practice Physicians
Christopher M. Williams, Christopher G. Maher, Mark J. Hancock, James H. McAuley, Andrew J. McLachlan, Helena Britt, Salma Fahridin, Christopher Harrison, and Jane Latimer
Arch Intern Med. 2010;170(3):271-277.
ABSTRACT | FULL TEXT