National clinical guidelines in municipality-based rehabilitation: A cross-sectional survey of knowledge, use, and implementation

Background: Despite increasing research within physiotherapy, consistent implementation of evidence-based guidelines in everyday physiotherapy practice can present a challenge. Objective: To examine the knowledge, use, and implementation of National Clinical Guidelines (NCG) for knee arthrosis and meniscus pathology in municipality-based rehabilitation in Denmark. Methods: A cross-sectional survey using a web-based questionnaire developed for the present study. Respondents included rehabilitation unit managers, staff in charge of professional development and physiotherapists from municipality-based rehabilitation units in one of the Denmark's five regions. Results: The questionnaire was completed by 61 respondents (75.3%). The responses indicated significantly better knowledge of the NCG for knee arthrosis than of the NCG for meniscus pathology (p = .017). Eighty-two percent (n = 50) replied that their unit had developed local guidelines for knee arthrosis; 74% (n = 45) for meniscus pathology. A total of 72% (n = 44) stated that relevant parts of the knee arthrosis NCG were integrated in local guidelines, whereas only 49% (n = 30) said the same for the meniscus pathology NCG. Respondents replied that implementation depends on factors such as time (46%, n = 28), knowledge (31%, n = 19), and the perceived relevance of the NCG (33%, n = 20) as well as support from local rehabilitation unit managers (23%, n = 14). Conclusion: Differences in the knowledge, use, and implementation of two NCGs among rehabilitation unit managers, staff in charge of professional development, and physiotherapists in municipality-based rehabilitation were identified. It seems that NCGs do not necessarily translate directly into local guidelines.

Automated summary

This study examined the knowledge, use, and implementation of National Clinical Guidelines (NCGs) for knee arthrosis and meniscus pathology in municipality-based rehabilitation units in Denmark. The results showed differences in the knowledge, use, and implementation of the two NCGs among rehabilitation unit managers, staff in charge of professional development, and physiotherapists. The study found that 82% of the respondents stated that their unit had developed local guidelines for knee arthrosis, while only 49% said the same for meniscus pathology. Factors such as time, knowledge, perceived relevance of the NCGs, and support from local rehabilitation unit managers were identified as influencing implementation.