Evidence-based treatment recommendations for neck and low back pain across Europe: A systematic review of guidelines.
Evidence-based treatment recommendations for neck and low back pain across Europe: A systematic review of guidelines.
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欧洲颈部和腰痛的循证治疗建议：指南的系统性综述。
DOI：
10.1002/ejp.1679
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发表时间：
2021-03
期刊：
影响因子：
--
通讯作者：
van der Windt DA
中科院分区：
文献类型：
--
作者：
Corp N;Mansell G;Stynes S;Wynne-Jones G;Morsø L;Hill JC;van der Windt DA
本系统综述综合了欧洲颈和腰痛（NLBP）临床实践指南（CPGs）的证据，以确定在欧洲范围内使用的推荐治疗方案。从2013年1月1日至2020年5月4日，对13个数据库进行了全面检索，以确定由专业机构/组织发布的用于NLBP初级保健管理的最新证据为基础的欧洲CPGs。提取的数据包括；目的和目标人群、制定和实施方法以及治疗建议。AGREE II检查表用于对指南进行批判性评估。制定标准是为了总结和综合各指南中建议的方向和力度。共鉴定了来自8个欧洲国家的17个cpg（11个下背，5个颈部，1个两个），其中7个为高质量。对于颈部疼痛，有一致的弱或中等强度的建议：安慰，建议和教育，手工治疗，转介运动治疗/计划，口服止痛药和局部药物，加上心理治疗或针对特定亚组的多学科治疗。背部疼痛和颈部疼痛之间值得注意的推荐差异包括：i)用于颈部疼痛的止痛药（不用于背部疼痛）；Ii)针对背痛的亚组选择——基于工作的干预措施、重返工作的建议/方案和手术干预（但不针对颈部疼痛）；iii)针对背痛的建议强度（一般为中等或强烈）大于针对颈部疼痛的建议强度。本综述对欧洲CPGs进行了回顾，确定了一系列主要是非药物推荐的NLBP治疗方案，这些方案在欧洲范围内具有广泛的共识。最近的欧洲临床实践指南对颈和腰痛（NLBP）患者的循证治疗建议达成共识，确定了广泛的非药物治疗方案。这包括可能适用于所有NLBP患者和仅适用于特定患者亚组的选择。我们的Back - UP研究团队未来的工作将把这些基于证据的治疗方案转移到一个可供首次接触临床医生使用的临床医生决策支持工具。
This systematic review synthesized evidence from European neck and low back pain (NLBP) clinical practice guidelines (CPGs) to identify recommended treatment options for use across Europe. Comprehensive searches of thirteen databases were conducted, from 1st January 2013 to 4th May 2020 to identify up‐to‐date evidence‐based European CPGs for primary care management of NLBP, issued by professional bodies/organizations. Data extracted included; aim and target population, methods for development and implementation and treatment recommendations. The AGREE II checklist was used to critically appraise guidelines. Criteria were devised to summarize and synthesize the direction and strength of recommendations across guidelines. Seventeen CPGs (11 low back; 5 neck; 1 both) from eight European countries were identified, of which seven were high quality. For neck pain, there were consistent weak or moderate strength recommendations for: reassurance, advice and education, manual therapy, referral for exercise therapy/programme, oral analgesics and topical medications, plus psychological therapies or multidisciplinary treatment for specific subgroups. Notable recommendation differences between back and neck pain included, i) analgesics for neck pain (not for back pain); ii) options for back pain‐specific subgroups—work‐based interventions, return to work advice/programmes and surgical interventions (but not for neck pain) and iii) a greater strength of recommendations (generally moderate or strong) for back pain than those for neck pain. This review of European CPGs identified a range of mainly non‐pharmacological recommended treatment options for NLBP that have broad consensus for use across Europe. Consensus regarding evidence‐based treatment recommendations for patients with neck and low back pain (NLBP) from recent European clinical practice guidelines identifies a wide range of predominantly non‐pharmacological treatment options. This includes options potentially applicable to all patients with NLBP and those applicable to only specific patient subgroups. Future work within our Back‐UP research team will transfer these evidence‐based treatment options to an accessible clinician decision support tool for first contact clinicians.
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影响因子：
3
作者：
Bouwmeester, Walter;van Enst, Annefloor;van Tulder, Maurits
通讯作者：
van Tulder, Maurits
影响因子：
2.9
作者：
Hill, J. C.;Garvin, S.;Foster, N. E.
通讯作者：
Foster, N. E.
影响因子：
4.7
作者：
Maserejian, Nancy N.;Fischer, Michael A.;Katz, Jeffrey N.
通讯作者：
Katz, Jeffrey N.
DOI：
10.1016/s0140-6736(18)32335-3
发表时间：
2018-11-10
期刊：
Lancet (London, England)
影响因子：
--
作者：
GBD 2017 DALYs and HALE Collaborators
通讯作者：
GBD 2017 DALYs and HALE Collaborators
影响因子：
2.2
作者：
Darlow, Ben;Dean, Sarah;Dowell, Anthony
通讯作者：
Dowell, Anthony