This study aimed to determine adherence to clinical practice guidelines in the medical, physiotherapy and chiropractic professions for acute and sub-acute mechanical low back pain through best-evidence synthesis of the health-care literature. A structured best-evidence synthesis of the relevant literature through a literature search of relevant databases for peer-reviewed papers on adherence to clinical practice guidelines from 1995 to 2013 was conducted. Inclusion of papers was determined by selection criteria and appraisal by two reviewers who independently applied a modified Downs & Black appraisal tool. The appraised papers were summarized in tabular form and analysed by the authors. The literature search found 23 possibly relevant papers that were evaluated for methodological quality, of which 11 studies met the inclusion criteria. The main finding was that no profession in the study consistently reached an overall high concordance rating. Of the three professions examined, 73% of chiropractors were adherent to current clinical practice guidelines, followed by physiotherapists (62%) and then medical practitioners (52%).
This review pointed out that there is a shortage of quality papers in this area of research. All the same, chiropractors seem to adhere to clinical practice guidelines more to a greater degree than physiotherapists and medical practitioners, although there is room for improvement across all three professions.