Cochrane · systematic review · CD007495
Professional interventions for general practitioners on the management of musculoskeletal conditions
Tzortziou Brown, V, Underwood, M, Mohamed, N, et al. · Cochrane Database of Systematic Reviews · 2016 · Cochrane Library
Effective Practice and Organisation of CareAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
61
current version
GRADE rated
29
No studies
32
Included studies
NR
No studies 32 · 52.5%Ungraded 0 · 0%Very low 0 · 0%Low 22 · 36.1%Moderate 5 · 8.2%High 2 · 3.3%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Primary care physician alerting system and a patient‐directed intervention (education and reminder to see their primary care physician) compared to standard care for osteoporosis management
Population: General practitioners/family doctors involved in the management of patients with osteoporosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Bone Mineral Density 1 Primary care physician alerting system and a patient‐directed intervention (education and reminder to see their primary care physician) vs standard care | RR 4.44 [3.54, 5.55] | 3 studies · 3386 participants | High |
Osteoporosis medication 2 Primary care physician alerting system and a patient‐directed intervention (education and reminder to see their primary care physician) vs standard care | RR 1.71 [1.5, 1.94] | 5 studies · 4223 participants | High |
Primary care physician alerting system compared to usual care for osteoporosis management
Population: General practitioners/family doctors involved in the management of patients with osteoporosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Bone mineral density1 Primary care physician alerting system vs usual care | RR 4.75 [3.62, 6.24] | 2 studies · 3047 participants | Moderate Downgraded: imprecision, inconsistency |
Osteoporosis medication2 Primary care physician alerting system vs usual care | RR 1.52 [1.26, 1.84] | 2 studies · 3047 participants | Moderate Downgraded: imprecision, inconsistency |
Primary care physician alerting system compared to primary care physician alerting system and a patient‐directed intervention (education and reminder to see their primary care physician) for osteoporosis management
Population: General practitioners/family doctors involved in the management of patients with osteoporosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Bone mineral density1 Primary care physician alerting system vs primary care physician alerting system and a patient‐directed intervention (education and reminder to see their primary care physician) | RR 0.94 [0.81, 1.09] | 2 studies · 2995 participants | Moderate Downgraded: imprecision |
Medication2 Primary care physician alerting system vs primary care physician alerting system and a patient‐directed intervention (education and reminder to see their primary care physician) | RR 0.93 [0.79, 1.1] | 2 studies · 2995 participants | Moderate Downgraded: imprecision |
Osteoporosis studies: Summary of findings
Population: General practitioners/family doctors involved in the management of patients with osteoporosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Health professional (GP) behaviour‐related outcomes Bone Mineral Density (BMD) testing Osteoporosis medication (appropriate prescribing) | no estimate extracted | 2 studies · 3047 participants | Moderate Downgraded: imprecision, inconsistency |
Patient outcomes Fragility fractures Hospitalisation | no estimate extracted | NR | No studies |
Economic outcomes Health service costs (including prescribing costs) Cost effectiveness | no estimate extracted | 1 study · 272 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Low back pain studies: Summary of findings
Population: General practitioners/family doctors involved in the management of patients with low back pain
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
H ealth professional (GP) behaviour‐related outcomes | no estimate extracted | NR | No studies |
Guideline‐consistent advice during consultation | no estimate extracted | NR | Low Downgraded: risk of bias, inconsistency |
Guideline‐consistent prescribing of medication | no estimate extracted | NR | Low Downgraded: risk of bias, inconsistency |
Guideline‐consistent referrals for investigations (e.g.. x‐rays) | no estimate extracted | NR | Low Downgraded: risk of bias, imprecision, inconsistency |
Guideline‐consistent referrals to other services | no estimate extracted | NR | Low Downgraded: risk of bias, imprecision, inconsistency |
Number of investigations | no estimate extracted | NR | Low Downgraded: risk of bias, imprecision, inconsistency |
Number of referrals to other services | no estimate extracted | NR | Low Downgraded: risk of bias, imprecision, inconsistency |
Patient outcomes | no estimate extracted | NR | No studies |
Functional capacity/activity scores | no estimate extracted | NR | No studies |
Pain control | no estimate extracted | NR | No studies |
Work absence | no estimate extracted | NR | Low Downgraded: risk of bias, imprecision, inconsistency |
Quality of life | no estimate extracted | NR | No studies |
Economic outcomes Health service costs (including prescribing costs) Cost effectiveness | no estimate extracted | NR | No studies |
Osteoarthritis studies: Summary of findings
Population: General practitioners/family doctors involved in the management of patients with osteoarthritis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Health professional (GP) behaviour‐related outcomes | no estimate extracted | NR | No studies |
Guideline‐consistent advice during consultation | no estimate extracted | NR | Low Downgraded: risk of bias, imprecision |
Guideline‐consistent prescribing of medication | no estimate extracted | NR | Low Downgraded: risk of bias, imprecision |
Guideline‐consistent referrals for investigations (e.g.. x‐rays) | no estimate extracted | NR | No studies |
Guideline‐consistent referrals to other services | no estimate extracted | NR | Low Downgraded: risk of bias, imprecision |
Number of investigations | no estimate extracted | NR | Low Downgraded: risk of bias, imprecision, inconsistency |
Number of referrals to other services | no estimate extracted | NR | Low Downgraded: risk of bias, imprecision, inconsistency |
Patient outcomes | no estimate extracted | NR | No studies |
Functional capacity/activity scores | no estimate extracted | NR | Low Downgraded: risk of bias, imprecision, inconsistency |
Pain control | no estimate extracted | NR | Low Downgraded: risk of bias, imprecision, inconsistency |
Work absence | no estimate extracted | NR | No studies |
Quality of life | no estimate extracted | NR | Low Downgraded: risk of bias, imprecision, inconsistency |
Economic outcomes Health service costs (including prescribing costs) Cost effectiveness | no estimate extracted | NR | No studies |
Shoulder pain studies: Summary of findings
Population: General practitioners/family doctors involved in the management of patients with shoulder pain
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Health professional (GP) behaviour‐related outcomes | no estimate extracted | NR | No studies |
Guideline‐consistent advice during consultation | no estimate extracted | NR | No studies |
Guideline‐consistent prescribing of medication | no estimate extracted | NR | No studies |
Guideline‐consistent referrals for investigations (e.g.. x‐rays) | no estimate extracted | NR | No studies |
Guideline‐consistent referrals to other services | no estimate extracted | NR | No studies |
Number of investigations | no estimate extracted | NR | Low Downgraded: risk of bias, imprecision |
Number of referrals to other services | no estimate extracted | NR | No studies |
Patient outcomes | no estimate extracted | NR | No studies |
Functional capacity/activity scores | no estimate extracted | NR | Low Downgraded: risk of bias, imprecision |
Pain control | no estimate extracted | NR | No studies |
Work absence | no estimate extracted | NR | No studies |
Quality of life | no estimate extracted | NR | No studies |
Economic outcomes Health service costs (including prescribing costs) Cost effectiveness | no estimate extracted | NR | Low Downgraded: risk of bias, imprecision |
Studies on other musculoskeletal conditions: Summary of findings
Population: General practitioners/family doctors involved in the management of patients with other musculoskeletal conditions
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Health professional (GP) behaviour‐related outcomes | no estimate extracted | NR | No studies |
Guideline‐consistent advice during consultation | no estimate extracted | NR | No studies |
Guideline‐consistent prescribing of medication | no estimate extracted | NR | Low Downgraded: risk of bias, imprecision |
Guideline‐consistent referrals for investigations (e.g.. x‐rays) | no estimate extracted | NR | No studies |
Guideline‐consistent referrals to other services | no estimate extracted | NR | No studies |
Number of investigations | no estimate extracted | NR | Low Downgraded: risk of bias, imprecision |
Number of referrals to other services | no estimate extracted | NR | No studies |
Patient outcomes | no estimate extracted | NR | No studies |
Functional capacity/activity scores | no estimate extracted | NR | No studies |
Pain control | no estimate extracted | NR | Low Downgraded: risk of bias, imprecision |
Work absence | no estimate extracted | NR | No studies |
Quality of life | no estimate extracted | NR | No studies |
Economic outcomes Health service costs (including prescribing costs) Cost effectiveness | no estimate extracted | NR | No studies |