J Can Chiropr Assoc. 2013 Dec; 57(4): 279–284.
PMCID: PMC3845467
André Bussières, DC, MSc, PhD, FCCS(C)
Background
One important reason patients consult primary care professionals, including general practitioners and chiropractors, is for musculoskeletal (MSK) conditions.1 Musculoskeletal conditions (spinal pain, consequences of injuries, osteoporosis, and arthritis) result in an enormous social, psychological, and economic burden to society1–8, and are the leading cause of physical disability.9 Chiropractic is a regulated health profession (serving approximately 10% of the population)10 that has contributed to the health and well-being of North Americans for over a century.
Despite available evidence for optimal management of back and neck pain11–13, poor adherence to clinical practice guidelines and wide variations in services have been noted.12,14,15 Utilization of clinical practice guidelines (CPGs) is an important way to help implement research findings into clinical practice. Guidelines aim to describe appropriate care based on the best available scientific evidence and broad consensus while promoting efficient use of resources.16,17 These tools have the potential to improve the quality and safety of healthcare.18,19
Over a decade ago, the Canadian Chiropractic Association (CCA) and the Canadian Federation of Chiropractic Regulatory and Education Accrediting Boards (CFCREAB or Federation) launched the CPG project to develop clinical practice guidelines in order to improve chiropractic care delivery in Canada. Guidelines developed by the CPG project include the management of neck pain due to whiplash injuries20, headaches21, and neck pain not due to whiplash22,23 (an update of which is expected by the end of 2013).
Recent advances in methods to conduct knowledge synthesis24, derive evidence-based recommendations25, adapt high quality guidelines26, and increase the uptake of Clinical Practice Guidelines27,28 have prompted an update of the DIER (development, dissemination, implementation, evaluation, and revision) Plan published in the JCCA (Journal of the Canadian Chiropractic Association) in 2004.29 The 140 page report was submitted to the stakeholders of the Guideline Initiative for consideration. The report updates the structure, methods and procedures for the development, dissemination and implementation of clinical practice guidelines in chiropractic. It is anticipated that new updates will be necessary as the art and science of guideline development, dissemination and implementation continue to evolve and new standards are established. The Full Report will be available on the new Guideline Initiative website, expected to be up and running in the first quarter of 2014.
This is the first paper of a two part presentation of the Guideline Initiative and its expected deliverables. The second paper will present the guideline development, dissemination, and implementation framework which will be the foundation of the Initiative. We intend to engage clinicians, leaders and decision makers in the profession right from the beginning as integral participants of the overall strategy to enhance patient care.