1. Can language enhance physical therapists' willingness to follow Choosing Wisely recommendations? A best-worst scaling study.
- Author
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Kharel P, Zadro JR, Ferreira G, Howell M, Howard K, Wortley S, McLennan C, and Maher CG
- Subjects
- Female, Humans, Male, Australia, Surveys and Questionnaires, Adult, Middle Aged, Low Back Pain therapy, Physical Therapists
- Abstract
Background: Choosing Wisely recommendations could reduce physical therapists' use of low-value care., Objective: To investigate whether language influences physical therapists' willingness to follow the Australian Physiotherapy Association's (APA) Choosing Wisely recommendations., Design: Best-worst Scaling survey METHODS: The six original APA Choosing Wisely recommendations were modified based on four language characteristics (level of detail, strength- qualified/unqualified, framing, and alternatives to low-value care) to create 60 recommendations. Physical therapists were randomised to a block of seven choice tasks, which included four recommendations. Participants indicated which recommendation they were most and least willing to follow. A multinomial logistic regression model was used to create normalised (0=least preferred; 10=most preferred) and marginal preference scores., Results: 215 physical therapists (48.5% of 443 who started the survey) completed the survey. Participants' mean age (SD) was 38.7 (10.6) and 47.9% were female. Physical therapists were more willing to follow recommendations with more detail (marginal preference score of 1.1) or that provided alternatives to low-value care (1.3) and less willing to follow recommendations with negative framing (-1.3). The use of qualified ('don't routinely') language (vs. unqualified - 'don't') did not affect willingness. Physical therapists were more willing to follow recommendations to avoid imaging for non-specific low back pain (3.9) and electrotherapy for low back pain (3.8) vs. recommendation to avoid incentive spirometry after upper abdominal and cardiac surgery., Conclusion: Physical therapists were more willing to follow recommendations that provided more detail, alternatives to low-value care, and were positively framed. These findings can inform the development of future Choosing Wisely recommendations and could help reduce low-value physical therapy., Competing Interests: Declaration of Competing Interest None declared., (Copyright © 2023 The Author(s). Publicado por Elsevier España, S.L.U. All rights reserved.)
- Published
- 2023
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