A combination of systematic review and clinicians' beliefs in interventions for subacromial pain
Language: 
English
Abstract: 

The aim of the study is to determine which treatments for patients with subacromial pain are trusted by general practitioners (GPs) and physiotherapists, and to compare trusted treatments with evidence from a systematic critical review of the scientific literature. A two-step process was used: a questionnaire (written case simulation) and a systematic critical review. The questionnaire was mailed to 188 GPs and 71 physiotherapists in Sweden. The total response rate was 72% (186/259). The following treatments were trusted, ergonomics/adjustments at work, corticosteroids, non-steroidal anti-inflammatory drugs, movement exercises, acupuncture, ultrasound therapy, strengthening exercises, stretching, transcutaneous electric nerve stimulation, and superficial heat or ice therapy. The review, including efficacy studies for the treatments found to be trusted, was conducted using the CINAHL, EMBASE and MEDLINE databases. Evidence for efficacy was recorded in relation to methodological quality and to diagnostic criteria that labelled participants as having subacromial pain or a non-specific shoulder disorder. Forty studies were included. The methodological quality varied and only one treatment had definitive evidence for efficacy for non-specific patients, namely injection of corticosteroids. The trust in corticosteroids, injected in the subacromial bursa, was supported by definitive evidence for short-term efficacy. Acupuncture had tentative evidence for short-term efficacy in patients with subacromial pain. Ultrasound therapy was ineffective for subacromial pain. This is supported by tentative evidence and, together with earlier reviews, this questions both the trust in the treatment and its use. The clinicians' trust in treatments had a weak association with available scientific evidence.

Author(s): 
Johansson, Kajsa
Oberg, Birgitta
Adolfsson, Lars
Foldevi, Mats
Item Type: 
Journal Article
Publication Title: 
The British Journal of General Practice: The Journal of the Royal College of General Practitioners
Journal Abbreviation: 
Br J Gen Pract
Publication Date: 
2002-02
Publication Year: 
2002
Pages: 
145-152
Volume: 
52
Issue: 
475
ISSN: 
0960-1643
Library Catalog: 
PubMed
Extra: 
PMID: 11885825 PMCID: PMC1314222

Turabian/Chicago Citation

Kajsa Johansson, Birgitta Oberg, Lars Adolfsson and Mats Foldevi. 2002-02. "A combination of systematic review and clinicians' beliefs in interventions for subacromial pain." The British Journal of General Practice: The Journal of the Royal College of General Practitioners 52: 475: 145-152.

Wikipedia Citation

<ref> {{Cite journal | doi = | issn = 0960-1643 | volume = 52 | pages = 145-152 | last = Johansson | first = Kajsa | coauthors = Oberg, Birgitta, Adolfsson, Lars, Foldevi, Mats | title = A combination of systematic review and clinicians' beliefs in interventions for subacromial pain | journal = The British Journal of General Practice: The Journal of the Royal College of General Practitioners | date = 2002-02 | pmid = | pmc = }} </ref>