Translating the Neck Pain Clinical Guidelines Into Practice: An Integrated Framework Approach

OBJECTIVE: To evaluate the implementation of the Academy of Orthopaedic Physical Therapy Neck Pain Clinical Practice Guidelines (CPGs) in a physical therapy department and assess adherence to evidence-based recommendations. DESIGN: Prospective observational cohort study. METHODS: The implementation strategy was guided by integration of the Donabedian Quality of Care Model and the Knowledge to Action Framework, incorporating a needs assessment, active training modules, self-audits, and electronic health record integration. Descriptive statistics characterized providers, compliance, and treatment adherence by impairment-based category. Chi-squared tests compared provider outcomes postimplementation. RESULTS: Twenty physical therapists participated comprising 67 patients for a total of 132 patient visits. The mean difference in confidence ratings across CPG components was +5.41 points (95% confidence interval: 3.79, 7.03) on the visual analog scale; however, this was not statistically significant ( P>.05). Compliance with outcome measure collection and CPG-recommended evaluation components was 92% (186/202) and 77% (213/278), respectively. Adherence to recommended interventions varied between impairment-based category, ranging from 46% to 68%. CONCLUSION: While providers were generally confident in applying the Neck Pain CPG, adherence in a clinical setting was suboptimal. The study underscores the importance of evaluating barriers and facilitators, tailored strategies, and refining implementation processes to improve guideline adherence and improve outcomes. JOSPT Open 2025;3(2):99-106. Epub 3 January 2025. doi:10.2519/josptopen.2025.0101