Clinical practice guidelines for the management of chronic musculoskeletal pain in primary healthcare : a systematic review
Date
2017-01-05
Journal Title
Journal ISSN
Volume Title
Publisher
BioMed Central
Abstract
ENGLISH SUMMARY : Background: Up-to-date, high quality, evidence-based clinical practice guidelines (CPGs) that are applicable for primary healthcare are vital to optimize services for the population with chronic musculoskeletal pain (CMSP). The study aimed to systematically identify and appraise the available evidence-based CPGs for the management of
CMSP in adults presenting in primary healthcare settings.
Methods: A systematic review was conducted. Twelve guideline clearinghouses and six electronic databases were searched for eligible CPGs published between the years 2000 and May 2015. CPGs meeting the inclusion criteria were appraised by three reviewers using the Appraisal of Guidelines Research and Evaluation (AGREE) II.
Results: Of the 1082 records identified, 34 were eligible, and 12 CPGs were included based on the inclusion and
exclusion criteria. The methodological rigor of CPG development was highly variable, and the median domain score
was 66%. The median score for stakeholder involvement was 64%. The lowest median score was obtained for the
domain applicability (48%). There was inconsistent use of frameworks to aggregate the level of evidence and the
strength of the recommendation in the included CPGs. The scope and content of the included CPGs focussed on
opioid prescription.
Conclusion: Numerous CPGs that are applicable for the primary healthcare of CMSP exists, varying in their scope
and methodological quality. This study highlights specific elements to enhance the development and reporting of
CPGs, which may play a role in the uptake of guidelines into clinical practice. These elements include enhanced
reporting of methodological aspects, the use of frameworks to enhance decision making processes, the inclusion of
patient preferences and values, and the consideration of factors influencing applicability of recommendations.
Description
CITATION: Ernstzen, D. V., Louw, Q. A. & Hillier, S. L. 2017. Clinical practice guidelines for the management of chronic musculoskeletal pain in primary healthcare: a systematic review. Implementation Science, 12:1, doi:10.1186/s13012-016-0533-0.
The original publication is available at https://implementationscience.biomedcentral.com
The original publication is available at https://implementationscience.biomedcentral.com
Keywords
Musculoskeletal system -- Wounds and injuries -- Treatment, Medical protocols, Primary health care, Systematic reviews (Medical research)
Citation
Ernstzen, D. V., Louw, Q. A. & Hillier, S. L. 2017. Clinical practice guidelines for the management of chronic musculoskeletal pain in primary healthcare: a systematic review. Implementation Science, 12:1, doi:10.1186/s13012-016-0533-0.