Evidence-based practice among Italian osteopaths: a national cross-sectional survey

BMC Complementary Medicine and Therapies - Tập 21 - Trang 1-10 - 2021
Francesco Cerritelli1, Alessio Iacopini1, Matteo Galli1, Oliver P. Thomson1,2, Tobias Sundberg3,4,5, Matthew J. Leach3,6, Jon Adams3
1Clinical-Based Human Research Department, Foundation COME Collaboration, Pescara, Italy
2University College of Osteopathy, London, UK
3Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, Australia
4Musculoskeletal and Sports Injury Epidemiology Center (MUSIC), Department of Health Promotion Sciences, Sophiahemmet University, Stockholm, Sweden
5Unit of Intervention and Implementation Research On Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
6National Centre for Naturopathic Medicine, Southern Cross University, Lismore, Australia

Tóm tắt

While evidence-based practice (EBP) is widely accepted across healthcare professions, research investigating its implementation in manual therapy professions such as osteopathy is limited. The primary aim of this study was to investigate Italian osteopaths’ attitudes, skills, and use of EBP. A secondary purpose was to understand the obstacles and enablers to EBP adoption in the Italian osteopathic context. A cross-sectional national survey was conducted (April to June 2020) among a sample of Italian osteopaths. Eligible participants were invited to complete the Italian-translated Evidence-Based practice Attitude and Utilization Survey (EBASE) anonymously online using various recruitment strategies, including email and social media campaigns. In addition to the three EBASE sub-scores (attitudes, skills and use), the demographic characteristics of the sample were considered. A total of 473 osteopaths responded to the survey. The sample appeared to represent the Italian osteopathic profession. The majority of participants had a favorable attitude toward EBP. Eighty-eight percent of respondents agreed that EBP was necessary for osteopathy practice and that scientific literature and research findings were beneficial to their clinical scenario (95%). Perceived skill levels in EBP were rated as moderate, with the lowest scores for items relating to clinical research and systematic review conduct. Apart from reading/reviewing scientific literature and using online search engines to locate relevant research papers, participant engagement in all other EBP-related activities was generally low. Clinical practice was perceived to be based on a very small proportion of clinical research evidence. The primary obstacles to EBP implementation were a dearth of clinical evidence in osteopathy, and poor skills in applying research findings. The primary enablers of EBP adoption were access to full-text articles, internet connectivity at work, and access to online databases. Italian osteopaths were largely supportive of evidence-based practice but lacked basic skills in EBP and rarely engaged in EBP activities. The updating of osteopathic training curriculum and professional formal regulation in Italy could provide a suitable framework to improve EBP skills and use.

Tài liệu tham khảo

Claridge JA, Fabian TC. History and development of evidence-based medicine. World J Surg. 2005;29(5):547–53. Glasziou P, Ogrinc G, Goodman S. Can evidence-based medicine and clinical quality improvement learn from each other? BMJ Qual Saf. 2011;20(Suppl 1):i13–7. Sackett DL, Rosenberg WM, Gray JA, Haynes RB, Richardson WS. Evidence based medicine: what it is and what it isn’t. BMJ. 1996;312(7023):71–2. Luckmann R. Evidence-based medicine: how to practice and teach EBM, 2nd edition: by David L. Sackett, Sharon E. Straus, W. Scott Richardson, William Rosenberg, and R. Brian Haynes, Churchill Livingstone, 2000. J Intensive Care Med. 2001;16(3):155–6. Greenhalgh T, Howick J, Maskrey N, for the Evidence Based Medicine Renaissance Group. Evidence based medicine: a movement in crisis? BMJ. 2014;348(4):g3725. Lunghi C, Baroni F. Cynefin framework for evidence-informed clinical reasoning and decision-making. J Am Osteopath Assoc. 2019;119(5):312–21. Sciomachen P, Arienti C, Bergna A, Castagna C, Consorti G, Lotti A, et al. Core competencies in osteopathy: Italian register of osteopaths proposal. Int J Osteopath Med. 2018;27:1–5. World Health Organization. Benchmarks for training in traditional/complementary and alternative medicine: benchmarks for training in osteopathy. 2010. Kasiri-Martino H, Bright P. Osteopathic educators’ attitudes towards osteopathic principles and their application in clinical practice: a qualitative inquiry. Man Ther. 2016;21:233–40. Thomson TOP, Petty NJ, Moore AP. Osteopaths’ professional views, identities and conceptions – a qualitative grounded theory study. Int J Osteopath Med. 2014;17(3):146–59. Sundberg T, Leach MJ, Thomson OP, Austin P, Fryer G, Adams J. Attitudes, skills and use of evidence-based practice among UK osteopaths: a national cross-sectional survey. BMC Musculoskelet Disord. 2018;19(1):439. Esteves JE, Zegarra-Parodi R, van Dun P, Cerritelli F, Vaucher P. Models and theoretical frameworks for osteopathic care – a critical view and call for updates and research. Int J Osteopath Med. 2020;35:1–4. Buchbinder R, Underwood M, Hartvigsen J, Maher CG. The Lancet Series call to action to reduce low value care for low back pain: an update. Pain. 2020;161:S57–64. Humpage C. Opinions on research and evidence based medicine within the UK osteopathic profession: a thematic analysis of public documents 2003–2009. Int J Osteopath Med. 2011;14(2):48–56. Cerritelli, van Dun PLS, Esteves JE, Consorti G, Sciomachen P, Lacorte E, et al. The Italian Osteopathic Practitioners Estimates and RAtes (OPERA) study: a cross sectional survey. PLoS One. 2019;14(1):e0211353. Repertorio atto n. 185/CSR. Conferenza Permanente per i rapporti tra lo Stato, le Regioni e le Province Autonome di Trento e Bolzano. 2020. http://www.statoregioni.it/it/conferenza-stato-regioni/sedute-2020/seduta-del-05112020/atti/repertorio-atto-n-185csr/. Accessed 13 Mar 2021. Leach MJ, Shaw R, Austin P, Fryer G, Thomson OP, Adams J, et al. Attitudes, skills, and use of evidence-based practice: a cross-sectional survey of Swedish osteopaths. Int J Osteopath Med. 2020;38:41–9. Leach MJ, Sundberg T, Fryer G, Austin P, Thomson OP, Adams J. An investigation of Australian osteopaths’ attitudes, skills and utilisation of evidence-based practice: a national cross-sectional survey. BMC Health Serv Res. 2019;19(1):498. Alvarez G, Justribo C, Sundberg T, Thomson OP, Leach MJ. A national cross-sectional survey of the attitudes, skills and use of evidence-based practice amongst Spanish osteopaths. BMC Health Serv Res. 2021;21(1):130. de Vet HCW. Measurement in medicine: a practical guide. Cambridge: Cambridge Univ. Press; 2011. EN 16686. New European standard for osteopathy services. https://www.cen.eu/news/brief-news/pages/news-2016-008.aspx. Accessed 23 Mar 2021. Leach MJ, Gillham D. Evaluation of the evidence-based practice attitude and utilization SurvEy for complementary and alternative medicine practitioners. J Eval Clin Pract. 2008;14(5):792–8. Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Guidelines for the process of cross-cultural adaptation of self-report measures. Spine. 2000;25(24):3186–91. World Health Organization. Process of translation and adaptation of instruments. 2021. https://www.who.int/substance_abuse/research_tools/translation/en/. Accessed 10 Apr 2021. Cerritelli, Consorti G, van Dun PLS, Esteves JE, Sciomachen P, Valente M, et al. The Italian Osteopathic Practitioners Estimates and RAtes (OPERA) study: how osteopaths work. Alameddine M, curatore. PLoS One. 2020;15(7):e0235539. da Silva TM, Costa LDCM, Garcia AN, Costa LOP. What do physical therapists think about evidence-based practice? A systematic review. Man Ther. 2015;20(3):388–401. Leach MJ, Gillham D. Are complementary medicine practitioners implementing evidence based practice? Complement Ther Med. 2011;19(3):128–36. Schneider MJ, Evans R, Haas M, Leach M, Hawk C, Long C, et al. US chiropractors’ attitudes, skills and use of evidence-based practice: a cross-sectional national survey. Chiropr Man Ther. 2015;23(1):16. Scurlock-Evans L, Upton P, Upton D. Evidence-based practice in physiotherapy: a systematic review of barriers, enablers and interventions. Physiotherapy. 2014;100(3):208–19. Alvarez G, Solà I, Sitjà-Rabert M, Fort-Vanmeerhaeghe A, Gich I, Fernández C, et al. A methodological review revealed that reporting of trials in manual therapy has not improved over time. J Clin Epidemiol. 2020;121:32–44. Hunt K, Ernst E. Evidence-based practice in British complementary and alternative medicine: double standards? J Health Serv Res Policy. 2009;14(4):219–23. Ramis M-A, Chang A, Conway A, Lim D, Munday J, Nissen L. Theory-based strategies for teaching evidence-based practice to undergraduate health students: a systematic review. BMC Med Educ. 2019;19(1):267. Hay-Smith EJC, Brown M, Anderson L, Treharne GJ. Once a clinician, always a clinician: a systematic review to develop a typology of clinician-researcher dual-role experiences in health research with patient-participants. BMC Med Res Methodol. 2016;16(1):95. Hellier S, Cline T. Factors that affect nurse practitioners’ implementation of evidence-based practice. J Am Assoc Nurse Pract. 2016;28(11):612–21. Lindström A-C, Bernhardsson S. Evidence-based practice in primary care occupational therapy: a cross-sectional survey in Sweden. Occup Ther Int. 2018;2018:5376764. Ilic I. Teaching evidence-based practice: perspectives from the undergraduate and post-graduate viewpoint. Ann Acad Med Singap. 2009;38(6):559–5.