ABSTRACT
OBJECTIVE: To investigate the current treatment policy of general practitioners (GPs) in patients with a lumbosacral radicular syndrome (LRS) compared with their clinical guideline. DESIGN: A cross sectional survey. METHODS: Sixty-three GPs completed questionnaires about their treatment policy in individual LRS patients at baseline and at six months follow-up. Simultaneously, 136 LRS patients of these GPs were interviewed at baseline, and at three and six month's follow-up. RESULTS: Of the 12 recommendations in the guideline related to history taking, four were not adhered to by the GPs in about 25% of the patients. Of the ten recommended physical examinations, three are not frequently carried out by the GPs. Almost 40% of the patients were referred to physiotherapy and 27% received muscle relaxants. CONCLUSION: The majority of the GPs support the content of the LRS guideline. Overall, there was a good adherence with the guideline for history taking and physical examination, and a moderate adherence for treatment policy.
Subject(s)
Clinical Competence , Guideline Adherence , Physicians, Family , Practice Guidelines as Topic , Radiculopathy/therapy , Adolescent , Adult , Aged , Cross-Sectional Studies , Female , Follow-Up Studies , Humans , Lumbosacral Region , Male , Middle Aged , Neuromuscular Agents/therapeutic use , Physical Therapy Modalities , Retrospective Studies , Syndrome , Treatment OutcomeABSTRACT
To establish to what extent neurosurgeons subscribe to the lumbosacral radicular syndrome (LRS) guideline, and to evaluate their current management of patients with LRS against the guideline. All active neurosurgeons in the Netherlands (n=92) were mailed a questionnaire about the guideline and data from 66 responders were analysed. Patients were recruited via seven of the participating neurosurgeons and were interviewed once by telephone. The medical records of the participating patients (n=163) were also examined. Of the 26 propositions in the LRS guideline, seven were not fully endorsed by the neurosurgeons. Three of these seven propositions may need updating based on "new evidence". The time between the onset of the LRS episode and the actual moment of surgery was considerably longer than that recommended in the guideline. Based on their current management of LRS patients, the neurosurgeons largely adhere with the LRS guideline.
