Guideline Implementation in Physiotherapy (GIPhT)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00962169
Recruitment Status : Unknown
Verified August 2009 by Radboud University.
Recruitment status was:  Recruiting
First Posted : August 19, 2009
Last Update Posted : August 19, 2009
Maastricht University Medical Center
ZonMw: The Netherlands Organisation for Health Research and Development
The University of Texas Health Science Center, Houston
Royal Dutch Society for Physiotherapy
Dutch Institute for Allied Health Care
Information provided by:
Radboud University

Brief Summary:
The purpose of this study is 1) to develop an intervention strategy to increase physiotherapists' adherence to evidence-based practice guidelines, 2) to try out this intervention on a small scale to determine what efficacy may be expected from it, and 3) to determine the value of a planned, systematic and theory-based approach that was followed in developing and implementing the intervention.

Condition or disease Intervention/treatment Phase
Low Back Pain Other: Behavioral and managerial Other: Behavioral and IT Not Applicable

  Show Detailed Description

Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 30 participants
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Health Services Research
Official Title: Development and Pilot Testing of an Implementation Strategy to Increase Physiotherapists'Adherence to Evidence-based Guideline for Patients With Low Back Pain: a Planned, Systematic and Theory-based Approach
Study Start Date : July 2009
Estimated Primary Completion Date : December 2009
Estimated Study Completion Date : December 2009

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Back Pain
U.S. FDA Resources

Arm Intervention/treatment
Experimental: Quality improvement program Other: Behavioral and managerial
The quality improvement program is a multi-level intervention program to increase adherence to the Dutch physical therapy Guidelines for Low Back Pain. It consists of two program parts, one for practice quality managers and the other for individual therapists. The management part aims to increase commitment amongst practice owners towards high quality of care, including the appropriate use of guidelines, and addresses the structure and the culture of the physical therapy practice. This part of the program is based on the INK management model and the colour model of De Caluwé. The individual part of the intervention is aimed at increasing physical therapists' guideline adherence by raising awareness and improving recording and clinical reasoning. This part of the intervention is based on psychosocial and educational theories and especially on the principles of Self Regulation.
Experimental: Electronic patient device (EPD) Other: Behavioral and IT
The interventions makes use of an improved EPD for physical therapists. Compared to the existing EPDs, the EPD for the present study presents decision information for physical therapists. This decision information is directly based on the recently revised physical therapy guidelines for Low Back Pain and attached to the subsequent steps of clinical reasoning that are inherent to the diagnostic and treatment stages of the usual process of physical therapy care.
Other Name: FysioDesk EPD.

Primary Outcome Measures :
  1. Guideline adherence [ Time Frame: 3 months ]

Secondary Outcome Measures :
  1. Determinants of guideline adherence [ Time Frame: 3 months ]

Information from the National Library of Medicine

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Ages Eligible for Study:   Child, Adult, Senior
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

Arm 1 Quality improvement program

  • Physiotherapy practices that have started or finalized a quality registration procedure (HNK)

Arm 2 Electronic patient device

  • Physiotherapists that are acquainted with the use of EPDs in their practice

Exclusion Criteria:

  • Physiotherapists enrolled in other quality improvement programs

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00962169

Contact: Geert Rutten, MPH +31 24 361 0591
Contact: Janneke Harting, PhD +31 24 361 0591

IQ healthcare / Radboud UMCN Recruiting
Nijmegen, Netherlands
Contact: Janneke Harting, PhD    +31 24 361 0591   
Sponsors and Collaborators
Radboud University
Maastricht University Medical Center
ZonMw: The Netherlands Organisation for Health Research and Development
The University of Texas Health Science Center, Houston
Royal Dutch Society for Physiotherapy
Dutch Institute for Allied Health Care
Study Director: Rob Oostendorp, Professor University Medical Center St Radboud Nijmegen

Bekkering GE. Physiotherapy guidelines for low back pain. Development, implementation, and evaluation. Vrije Universiteit Amsterdam, 2004. Fritz JM, Cleland JA, Brennan GP. Does adherence to the guideline recommendation for active treatments improve the quality of care for patients with acute low back pain delivered by physical therapists? Med Care 2007;45(10):973-80. Grimshaw JM, Thomas RE, MacLennan G, Fraser C, Ramsay CR, Vale L, et al. Effectiveness and efficiency of guideline dissemination and implementation strategies. Health Technol Assess 2004;8(6 iii-iv):1-72. Harting J, Rutten GM, Rutten ST, Kremers SP. A Qualitative Application of the Diffusion of Innovations Theory to Examine Determinants of Guideline Adherence Among Physical Therapists. Phys Ther 2009. Rutten G, Kremers S, Rutten S, Harting J. A theory-based cross-sectional survey demonstrated the important role of awareness in guideline implementation. J Clin Epidemiol 2009;62(2):167-176 e1. Rutten GMJ, Harting J, Rutten STJ, Bekkering GE, Kremers SPJ. Measuring physiotherapists' guideline adherence by means of clinical vignettes: a validation study. J Eval Clin Pract 2006;12(5):491-500.

Responsible Party: Prof. Dr. RAB Oostendorp, University Medical Center St Radboud Nijmegen Identifier: NCT00962169     History of Changes
Other Study ID Numbers: ZonMw 80-007028-98-07309
CMO 2007/172
First Posted: August 19, 2009    Key Record Dates
Last Update Posted: August 19, 2009
Last Verified: August 2009

Keywords provided by Radboud University:
Guideline adherence
Physical therapy
Low back pain
Health plan implementation

Additional relevant MeSH terms:
Back Pain
Low Back Pain
Neurologic Manifestations
Nervous System Diseases
Signs and Symptoms