Table 1 Study characteristics
Author, year | Sample size | Design | Clinic setting; country of origin | Key implementation process | Implementation strategy | Risk of bias (Downs & Black) |
|---|---|---|---|---|---|---|
Low back pain | ||||||
 Bekkering, 2005 [29] | 500 Patients 113 PTs | Cluster RCT | Outpatient Clinic: Private Practice; The Netherlands | Planning; Educating; Managing Quality | Tailor strategies to overcome barriers and honor preferences; distribute education materials; conduct educational meetings; make training dynamic; model and simulate change; audit and provide feedback; remind clinicians | 23 |
 Childs, 2015 [22] | 753,540 Patient charts 112,723 (16%) Patients utilizing physical therapy | Retrospective Cohort | Military Treatment Facilities and Clinics Reimbursed by TriCare; Global: MHS | Managing Quality | Use data warehousing techniques; use data experts; audit and provide feedback | 17 |
 Feuerstein, 2006 [33] | 15,789 Patients | Longitudinal Panel Study and Cross Sectional | Military Healthcare System Outpatient Clinics; Global: MHS | Planning; Educating; Managing Quality | Conduct local needs assessment; identify and prepare champions; use advisory boards and work groups; develop a formal implementation blueprint; develop effective educational materials; distribute educational materials; purposely re-examine the implementation; audit and provide feedback; use data warehousing techniques; use data experts | 20 |
 Fritz, 2012 [16] | 32,070 Patients 2234 Patients utilizing physical therapy | Retrospective Cohort | Outpatient Clinics: Private, Non-profit; United States: Utah | Managing Quality | Use data warehouse techniques; use data experts; audit and provide feedback | 20 |
 Hoeijenbos, 2005 [25] | 500 Patients 113 Physiotherapists | Cluster RCT | Outpatient Clinic: Private Practice; The Netherlands | Educating; Managing Quality | Distribute education materials; conduct educational meetings; make training dynamic; develop effective educational materials; audit and provide feedback; remind clinicians | 19 |
 Karlen, 2015 [36] | 47,755 Patient episodes 32 Outpatient clinics | Case Report | Outpatient Clinics; United States | Planning; Educating; Restructuring; Managing Quality | Conduct local needs assessment; assess for readiness and identify barriers; tailor strategies to overcome barriers and honor preferences; conduct local consensus discussions; involve executive boards; identify and prepare champions; recruit designate and train for leadership; mandate change; develop effective educational materials; distribute educational materials; conduct educational meetings; conduct ongoing training; make training dynamic; revision of professional roles; facilitate relay of clinical data to providers; develop and organize quality monitoring systems; purposely re-examine the intervention; audit and provide feedback; use advisory boards and work groups; capture and share local knowledge; organize clinician implementation team meetings | 12 |
 Kongsted, 2019 [32] | 250 Patients 31 Clinicians | Longitudinal Cohort, feasibility study | Outpatient Clinics; Denmark | Planning; Educating; Managing Quality | Develop academic partnerships; work with educational institutions; conduct educational meetings; make training interactive; distribute educational materials; develop and organize quality monitoring systems; audit and provide feedback; purposely re-examine the implementation; use data warehousing techniques | 16 |
 Lemieux, 2021 [30] | 78 Patients 35 Clinicians | Longitudinal Cohort, feasibility study | Outpatient Clinics; Canada | Educating ; Managing Quality; Financing | Conduct educational meetings; develop effective education materials; make training dynamic; distribute educational materials; purposely re-examine the implementation; use data warehousing techniques; use other payment schemes | 16 |
 Magel, 2018 [34] | 400 Patients | Prospective Observational Cohort | Outpatient Clinics; United States | Planning; Managing Quality | Conduct local needs assessment; assess for readiness and identify barriers; tailor strategies to overcome barriers and honor preferences; use advisory boards and workgroups; audit and provide feedback, purposely re-examine the implementation; remind clinicians; intervene with patients/consumers to enhance uptake and adherence | 20 |
 Rutten, 2010 [35] | 145 Patients 61 PTs | Prospective Observational Cohort | Outpatient Clinics: Private Practice; The Netherlands | Managing Quality | Use data warehousing techniques; use data experts; audit and provide feedback; develop tools for quality monitoring | 18 |
 Sharma, 2019 [26] | 40 Patients | Two-arm, parallel, assessor-blinded, feasibility RCT | Rehabilitation Hospital; Nepal | Planning; Educating | Conduct local needs assessment, Develop effective educational materials, involve patients/consumers and family members, Distribute educational material | 22 |
 Schroder, 2021 [23] | 500 Patients 123 PTs | Cluster RCT | Outpatient Clinics: Public ; Sweden | Planning; Educating; Managing Quality | Conduct local needs assessment; Tailor strategies to overcome barriers and honor preferences; Develop a formal implementation blueprint; Identify and prepare champions; Develop effective education materials; Distribute education materials; Conduct educational meetings; Conduct ongoing training; Use advisory boards and workgroups; Obtain and use patient/consumer and family feedback; Purposely re-examine the implementation | 20 |
 Swinkels, 2005 [21] | 1254 Patient charts 90 Therapists from 40 practices | Retrospective Cohort | Outpatient Clinics: Private Practice; The Netherlands | Educating; Managing Quality | Distribute education materials; use data warehousing techniques; use data experts; audit and provide feedback | 17 |
Acute low back pain | ||||||
 Fritz, 2007 [17] | 1190 Patient charts | Retrospective Cohort | Outpatient Clinics: Private, Non-profit; United States: Utah | Managing Quality | Use data warehousing techniques; use data experts; audit and provide feedback | 18 |
 Fritz, 2008 [18] | 471 Patients | Retrospective Cohort | Outpatient physical therapy clinics in the Rehabilitation Agency of Intermountain Healthcare (IHC) system; United States: Utah | Educating; Managing Quality | Distribute educational materials; use data warehousing techniques; use data experts; audit and provide feedback | 14 |
 Owens, 2019 [20] | 105 Patients | Retrospective Cohort | Outpatient: Workers Compensation; United States | Managing Quality | Use data warehousing techniques; use data experts; audit and provide feedback | 19 |
Chronic low back pain | ||||||
 Van der Roer, 2008 [24] | 120 Patients | RCT | Outpatient Clinics; The Netherlands | Managing Quality | Use data experts; audit and provide feedback | 16 |
Low back pain with radicular symptoms | ||||||
 Fleuren, 2010 [31] | 723 Patients 360 General practitioners, 550 physiotherapists, 9 neurologists, 18 radiologists | Longitudinal Cohort | Outpatient Rehabilitation Clinics; The Netherlands | Planning; Educating; Managing Quality | Conduct local needs assessment; assess readiness and identify barriers; tailor strategies to overcome barriers and honor preferences; conduct local consensus discussions; recruit, designate, and train for leadership; develop effective educational materials; distribute educational materials; conduct educational meetings; conduct ongoing training; provide ongoing consultation; use mass media; audit and provide feedback; remind clinicians; purposely re-examine the implementation; use an improvement/implementation advisor; organize clinician implementation team meetings | 16 |
 Hahne, 2017 [27] | 54 Patients | Subgroup analysis of multicenter RCT | Outpatient Clinics; Australia | Educating; Managing Quality | Conduct educational meetings; develop effective education materials; distribute education materials; provide ongoing consultation; audit and provide feedback | 22 |
Neck pain | ||||||
 Cote, 2019 [28] | 340 Participants | Pragmatic RCT | Multidisciplinary Rehabilitation Clinics; Canada | Financing; Educating | Place on fee for service lists/formularies; fund and contract for the clinical innovation; conduct educational meetings; distribute education materials | 26 |
 Horn, 2016 [19] | 298 Patients | Retrospective Cohort | Outpatient Clinics; United States | Managing Quality | Use data warehousing techniques; use data experts; audit and provide feedback | 19 |