Limited adherence to clinical practice guidelines among Belgian Physiotherapists: Findings from a 2014-2016 cross-sectional study.

BACKGROUND AND PURPOSE: Despite evidence-based clinical guidelines promoting a biopsychosocial approach to managing low back pain, physiotherapists often fail to adhere to these recommendations, influenced by their attitudes. Therefore, this study aimed to explore Belgian physiotherapists' beliefs and attitudes toward low back pain management.

METHODS

An observational, cross-sectional study was conducted in Belgium between 2014 and 2016. Physiotherapists' beliefs were evaluated using the Pain Attitudes and Beliefs Scale for Physiotherapists (PABS-PT), which contains a biomedical and psychosocial subscale, and Health Care Providers' Pain and Impairment Relationship Scale (HC-PAIRS). A clinical vignette was used to assess physiotherapists' adherence to guidelines recommending physical activity and work for low back pain. Associations between physiotherapists' demographics, PABS-PT subscales and HC-PAIRS were assessed using Student T-tests and chi-square for group differences, and Pearson's R for correlations.

RESULTS

A total of 565 physiotherapists participated. Out of 561 physiotherapists, 59.5 % provided guideline-adherent recommendations regarding physical activity and 33.9 % out of 560 regarding work. Physiotherapists with a stronger biomedical and weaker biopsychosocial orientation were less likely to adhere to guidelines concerning work and activity. Beliefs and adherence to guidelines were associated with years since graduation and socio-cultural differences. Sex-based differences were observed in guideline adherence related to activity, with male physiotherapists showing greater compliance.

CONCLUSION

The study provides evidence that between 2014 and 2016, guideline adherence among physiotherapists in Belgium was low and related to their attitudes and beliefs about low back pain. These attitudes, beliefs and guideline adherence were associated with physiotherapists' graduation year and socio-cultural factors.