背景:下腰痛(LBP)是导致残疾和高昂医疗费用的常见病。艾伯塔省面临着不必要的转介专家和漫长的等待时间的挑战。基于循证最佳实践的全省标准化临床护理路径可以提高效率,减少等待时间,并提高患者的治疗效果。实施这些途径在艾伯塔省的其他医疗保健领域取得了成功。这项研究开发了一种临床决策途径,以标准化护理并最大程度地减少评估的不确定性。诊断,和管理。
方法:系统快速评价确定了现有的工具和证据,可以支持全面的LBP临床决策工具。47名医疗保健专业人员参加了四轮修改后的Delphi方法,以就评估达成共识,诊断,以及在艾伯塔省接受LBP治疗的患者的管理,加拿大。该项目是艾伯塔省卫生服务机构骨与关节健康战略临床网络(BJHSCN)和艾伯塔省骨与关节健康研究所(ABJHI)之间的合作努力。
结果:由来自不同卫生学科和地区的专业人员组成的全省专家小组合作开发了LBP临床决策工具。该工具提供了急性,亚急性,和慢性LBP。它还为历史记录提供指导,体检,患者教育,和管理。
结论:该临床决策工具将有助于标准化护理,为LBP的诊断和管理提供指导,并协助公共和私营部门的初级保健提供者的临床决策。
BACKGROUND: Low back pain (LBP) is a common condition causing disability and high healthcare costs. Alberta faces challenges with unnecessary referrals to specialists and long wait times. A province-wide standardized clinical care pathway based on evidence-based best practices can improve efficiency, reduce wait times, and enhance patient outcomes. Implementing such pathways has shown success in other areas of healthcare in Alberta. This study developed a clinical decision-making pathway to standardize care and minimize uncertainty in assessment, diagnosis, and management.
METHODS: A systematic rapid review identified existing tools and evidence that could support a comprehensive LBP clinical decision-making tool. Forty-seven healthcare professionals participated in four rounds of a modified Delphi approach to reach
consensus on the assessment, diagnosis, and management of patients presenting to primary care with LBP in Alberta, Canada. This project was a collaborative effort between Alberta Health Services\' Bone and Joint Health Strategic Clinical Network (BJHSCN) and the Alberta Bone and Joint Health Institute (ABJHI).
RESULTS: A province-wide expert panel consisting of professionals from different health disciplines and regions collaborated to develop an LBP clinical decision-making tool. This tool presents clinical care pathways for acute, subacute, and chronic LBP. It also provides guidance for history-taking, physical examination, patient education, and management.
CONCLUSIONS: This clinical decision-making tool will help to standardize care, provide guidance on the diagnosis and management of LBP, and assist in clinical decision-making for primary care providers in both public and private sectors.