Compliance with clinical practice guidelines in family physicians managing worker's compensation board patients with acute lower back pain.

BACKGROUND CONTEXT: Family physician compliance with acute lower back pain clinical practice guidelines remains uncertain.

PURPOSE: To determine the degree of guideline compliance of family physicians managing patients with workers' compensation claims and acute mechanical lower back pain.

STUDY DESIGN: Observational study.

PATIENT SAMPLE: One hundred thirty-nine family physicians in British Columbia.

OUTCOME MEASURES: Compliance with guideline recommendations for history, examination procedures, diagnostic testing and treatments.

METHODS: Physician workers' compensation board patient reports for acute lower back pain without leg symptoms and not greater than 2 to 3 weeks duration were scored for guideline adherence up until 12 weeks after onset.

RESULTS: Physicians demonstrated a high degree of compliance with the guideline-recommended history, examination procedures and medications, but low compliance with recommended imaging and many treatment recommendations.

CONCLUSIONS: Recently published clinical practice guidelines regarding the management of patients with acute mechanical lower back pain have not been fully implemented into the patterns of practice of the family physicians.