{
  "abstract": "Background Choosing Wisely is a global campaign encouraging healthcare professionals to provide high-quality patient care. Numerous studies across various health disciplines have investigated the effect of the Choosing Wisely campaign on reducing overuse of healthcare. However, findings have been mixed and no high-quality studies have evaluated the impact of the Choosing Wisely recommendations on physiotherapy practice.Aim The study aimed to assess the effect of Choosing Wisely recommendations on physiotherapists’ intentions to refer for imaging and use electrotherapy for low back painStudy Design/Setting Three-arm parallel-group online randomised controlled trial were included.Patient Sample 473 physiotherapists who treated people with low back pain.Outcome Measures Primary outcomes were physiotherapists’ intentions to refer for imaging and use electrotherapy for low back pain. Secondary outcomes were physiotherapists’ intentions to use other treatments for low back pain, the influence of the recommendations on decision-making in the vignettes and familiarity with the recommendations.Methods Physiotherapists who treat people with low back pain were randomised to receive: i) the two original Australian Physiotherapy Association (APA) Choosing Wisely recommendations about low back pain, ii) two optimised versions of these recommendations based on previous research, and iii) no recommendations. Participants were then directed to read three clinical vignettes of a person with low back pain and respond to questions regarding each vignette.Results A total of 723 participants opened the survey and 473 (65%) provided complete responses. Across all vignettes, there were no statistically significant differences in intentions to refer for imaging, use electrotherapy or use other treatments. This was consistent between those who received Choosing Wisely recommendations versus no recommendation and those who received the optimised versus original recommendations. Modifying the language to make the Choosing Wisely recommendations clearer and more positive did not change physiotherapists’ clinical behaviour. 63% of participants reported feeling influenced by the recommendations, with most being familiar and agreeing with the recommendations.Conclusions Our results suggest that simply presenting Choosing Wisely recommendations to physiotherapists does not influence their intentions to refer for imaging or use electrotherapy for low back pain even if the language of the recommendations is optimised. While physiotherapists showed a high level of familiarity and agreement with the Choosing Wisely recommendations, the recommendations did not influence their intentions to refer for imaging or use electrotherapy for low back pain. There is a need for studies that evaluate multicomponent implementation strategies to implement these recommendations to align physiotherapists’ practices more closely with evidence-based guidelines.",
  "authors": [
    {
      "affiliations": [
        "University of Sydney, Camperdown, Australia"
      ],
      "name": "Priti Kharel"
    }
  ],
  "title": "004 Effectiveness of choosing wisely recommendations in reducing physiotherapists’ intentions to refer for imaging and use electrotherapy for low back pain: a randomised controlled experiment",
  "uid": "174bad10-2ebc-58b9-91de-b18a59324b03"
}