Doctors’ network promotes back pain evidence among peers

A network of 200 Ontario physicians has been learning the most recent evidence on back pain treatment. The question now is whether they effectively influence peers to change their practice – and whether the network can be maintained over time.

The network was established by the Institute for Work & Health and several other partners. An evaluation of the project is now underway.

We are trying to see if physicians will align practice with the evidence on low-back pain, says Rhoda Reardon, a Knowledge Transfer Associate at IWH. Reardon helped set up the network, which involves the province’s Guidelines Advisory Committee (GAC), the Ontario College of Family Physicians, the College of Physicians and Surgeons of Ontario, and the Knowledge Translation Program at the University of Toronto.

The committee plans to use this network on an ongoing basis to promote other research-based evidence and clinical guidelines. They would also like to collect information from physicians to improve projects on research, leadership and guideline development.

The physicians are called “Educationally Influential” (EI) because they were identified by their peers, through a structured questionnaire, as acting as informal influencers with colleagues. The network is called POCKET: Physicians of Ontario Collaborating for Knowledge Exchange and Transfer.

At an initial meeting, the EI physicians indicated that the focus, which was originally on acute low-back pain, was too narrow. They also asked for guidance on interacting with the Workplace Safety & Insurance Board (WSIB), as many back-pain patients were involved with the WSIB. The Guidelines’ EI steering committee responded by expanding the focus to include chronic back pain, and by developing a physician’s reference guide to the WSIB.

Since then, physicians have been invited to attend one of seven regional meetings or two videoconferences about EI networks. They also heard evidence on low-back pain management from a clinician/researcher, including Drs. Jaime Guzman and Andrea Furlan from the Institute.

In addition, the physicians were asked how best to promote the message to other doctors. One result is a physician tool kit with a variety of components, including a booklet summarizing the evidence on chronic low-back pain management; a CD-ROM showing how to examine a patient’s back in three minutes or less; a prescription pad, which reinforces evidence-based messages for managing acute low back pain; a back pain information booklet, and other items.

The kit will go to all EI physicians but distribution could be wider, depending on the evaluation, says Reardon. As part of the evaluation, we will be asking, ‘Is it feasible to carry on with the network? Is this a useful way to move knowledge out?’

The Guidelines Advisory Committee is a joint project of the Ontario Medical Association and the Ministry of Health and Long-term Care.

Source: At Work, Issue 46, Fall 2006: Institute for Work & Health, Toronto