Evaluating two implementation strategies for whiplash

Trudy Rebbeck, Christopher G Maher and Kathryn M Refshauge

The purpose of this study was to discover if implementation strategies involving education are any more effective than mere dissemination of clinical practice guidelines in changing physiotherapy practice and reducing patient disability after acute whiplash.   The implementation group of physiotherapists underwent education by opinion leaders about whiplash guidelines and the dissemination group had the guidelines mailed to them.  The results showed that there were no significant differences between groups for any of the patient outcomes at any time. The implementation patients had 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 less than for patients in the
dissemination group. The authors conclude that although the active implementation program increased guideline-consistent practice, patient outcomes and cost of care were not affected.

Australian Journal of Physiotherapy, Septemner 2006, 52: 165–174

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