Exploring physiotherapists’ use of clinical practice guidelines, screening, and stratification tools for people with low back pain in New Zealand

Abstract

Low back pain (LBP) is a leading cause of disability in New Zealand and is associated with significant treatment and societal costs. Clinical practice guidelines (CPGs) for LBP increasingly recommend the use of screening and stratification tools to aid the early identification of psychosocial factors that can contribute to chronic LBP. This survey of New Zealand physiotherapists examined their use of CPGs, screening, and stratification tools in clinical practice, and identified their perceived barriers to using these tools. In total, 228 physiotherapists completed the survey. Over half of the respondents (53%) regularly used CPGs for LBP in clinical practice, with the Accident Compensation Corporation's New Zealand Acute Low Back Pain Guide being the most commonly used guideline (84%). Most (94%) respondents reported screening people with LBP for psychosocial factors; 37% used formal screening tools and 22% used risk stratification tools. Key perceived barriers to using CPGs, screening, and stratification tools included lack of training and exposure, time constraints, and lack of resources. An analysis using chi-square tests revealed significant associations (p < 0.05) between the use of screening tools, and postgraduate qualifications and years of experience. Further research is required to better understand whether a stratified model of care for LBP may be implemented in New Zealand and the supports required to ensure the success of such a model.