@misc{PieperBehnkeDumkeetal., author = {Pieper, Dawid and Behnke, Eva-Maria and Dumke, Rieke and Kehr-Fuckel, Christel and Radow, Carolin and Schulze, Nils and Follmann, Markus and Schaefer, Corinna and Prill, Robert and Kopkow, Christian and Bahns, Carolin and Choi, Kyung-Eun (Anna) and Fischer, Lena}, title = {Awareness of adapting clinical practice guidelines to a local context}, series = {Clinical and public health guidelines}, volume = {2}, journal = {Clinical and public health guidelines}, number = {3}, publisher = {Wiley}, address = {Hobken, New Jersey}, issn = {2836-3973}, doi = {10.1002/gin2.70025}, pages = {1 -- 7}, abstract = {Background Guideline recommendations are often not implemented in practice. This can be attributed to factors such as patient preferences and characteristics, structural conditions, personnel or other resources, as well as cultural or ethical aspects. Adaptations to the local context (e.g., regional or hospital) result in so-called locally adapted guidelines (LAGL), which could improve implementation. We aimed to assess the awareness of LAGL among guideline developers in Germany. Methods An online survey was conducted via LimeSurvey in May 2024. The questionnaire, designed based on literature and expert opinions, consisted of 23 items, predominantly with dichotomous response options. Recruitment was conducted via email. Direct contact addresses were identified using the German guideline registry (n = 397). Additionally, a mailing list distribution was conducted through the guidelines working group of the German Network for Evidence-Based Medicine (n = 316). Only fully completed questionnaires were included in the analysis. Data cleaning and descriptive analysis were performed using Excel. Results A total of 63 questionnaires were fully completed. The most represented groups were physicians (65\%) and methodologists (24\%), most frequently in coordination (76\%) or as group members (62\%). The most judicious reasons for developing a LAGL were differences in patient populations (48\%), currency of recommendations (46\%), and patient values and preferences (44\%). The most commonly cited likely reasons for developing a LAGL were economic considerations (32\%), differences in patient populations (30\%), and currency of recommendations (30\%). Many respondents (59\%) were aware of the possibility of adapting existing guidelines to the local context. Among these, approximately half (49\%) had already locally adapted a guideline, with 75\% using an adaptation framework. Discussion LAGLs are known among guideline developers in Germany and are generally developed using adaptation frameworks. Potential reasons for preparing LAGLs are diverse, with some discrepancies between perceived valid and likely reasons. Highlights Over half (59\%) of surveyed clinical practice guideline (CPG) developers in Germany were aware of the possibility of adapting CPGs to local contexts, and nearly half of them had practical experience doing so. Although several adaptation frameworks exist, only 44\% of experienced adaptors were familiar with them, and among users, many found them only partly helpful. Differences in patient populations, outdated recommendations, and patient values were rated as the most valid reasons for local CPG adaptation, while economic factors were seen as the most likely driver in practice. Despite existing awareness, guideline adaptation to local settings remains underutilized and lacks structured implementation, highlighting the need for clearer definitions, better resources, and more practical examples.}, language = {en} } @misc{BraunBahnsElsneretal., author = {Braun, Tobias and Bahns, Carolin and Elsner, Bernhard and Kopkow, Christian}, title = {Forschungspriorit{\"a}ten in der physiotherapeutischen Forschung in Deutschland : eine systematische Anaylse von Publikationen der Physioscience der letzten 10 Jahre}, series = {Physioscience}, volume = {18}, journal = {Physioscience}, number = {2}, issn = {1860-3092}, doi = {10.1055/a-1549-5166}, pages = {77 -- 88}, language = {de} } @misc{BraunEhrenbrusthoffBahnsetal., author = {Braun, Tobias and Ehrenbrusthoff, Katja and Bahns, Carolin and Happe, Lisa and Kopkow, Christian}, title = {Cross-cultural adaptation, internal consistency, test-retest reliability and feasibility of the German version of the evidence-based practice inventory}, series = {BMC health services research}, volume = {19}, journal = {BMC health services research}, number = {1}, issn = {1472-6963}, doi = {10.1186/s12913-019-4273-0}, pages = {17}, language = {en} } @misc{BraunEhrenbrusthoffBahnsetal., author = {Braun, Tobias and Ehrenbrusthoff, Katja and Bahns, Carolin and Happe, Lisa and Kopkow, Christian}, title = {What's a true change? - Interpreting change scores in measurement instruments of evidence-based practice : a comment}, series = {Complementary Therapies in Medicine}, volume = {54}, journal = {Complementary Therapies in Medicine}, issn = {1873-6963}, doi = {10.1016/j.ctim.2020.102454}, pages = {2}, language = {en} } @misc{BahnsHappeKopkow, author = {Bahns, Carolin and Happe, Lisa and Kopkow, Christian}, title = {Barriers and facilitators to the use of clinical practice guidelines in osteoarthritis care: a qualitative study among German physiotherapists}, series = {BMJ Open}, volume = {14}, journal = {BMJ Open}, number = {10}, publisher = {BMJ}, issn = {2044-6055}, doi = {10.1136/bmjopen-2024-085349}, abstract = {Objectives The objective of this study was to explore barriers and facilitators to the use of clinical practice guidelines (CPGs) in osteoarthritis (OA) care among German physiotherapists. Design Qualitative semistructured interviews were conducted with German physiotherapists. An interview topic guide based on the Theoretical Domains Framework (TDF) was developed to explore perceived barriers and facilitators to the use of CPGs in OA care. Interviews were audio-recorded and transcribed verbatim. In a first step, the data were coded inductively using thematic analysis. Subsequently, the emerged themes were deductively reassigned to the relevant domains of the TDF and categorised as barriers and facilitators. Setting Outpatient physiotherapy practices in Germany. Participants Physiotherapists working in an outpatient setting in Germany and involved in the management of patients with hip and knee OA were eligible to participate. Results Eleven physiotherapists (7 women, 4 men) were interviewed between February and September 2023. The mean age was 34.2 years (± 9.9, range 23-57). Most factors influencing guideline-recommended care were identified in the TDF domains 'knowledge', 'beliefs about consequences', 'environmental context and resources' and 'social influences'. For example, physiotherapists perceived low awareness of existing CPGs, loss of individuality in treatment, time constraints and dissonant patient expectations as barriers to the use of CPGs. Discussion of guideline recommendations within the team and the expectation of improved patient outcomes and resource savings were reported as facilitators. Conclusions Multiple factors were identified that were perceived to influence clinical practice in Germany. The results of this study can inform the development of theory-based interventions aimed at changing physiotherapists' behaviour to support them in providing optimal OA care.}, language = {en} } @misc{BahnsKopkow, author = {Bahns, Carolin and Kopkow, Christian}, title = {Physiotherapy for patients with hip and knee osteoarthritis in Germany: a survey of current practice}, series = {BMC Musculoskeletal Disorders}, volume = {24}, journal = {BMC Musculoskeletal Disorders}, issn = {1471-2474}, doi = {10.1186/s12891-023-06464-0}, abstract = {Backround Osteoarthritis (OA) of the hip and the knee is common and leads to pain, stiffness and disability. Clinical practice guidelines (CPG) provide recommendations to assist healthcare professionals in clinical decision-making. Although evidence-based physiotherapy has been shown to be effective in the management OA, a gap between clinical practice and guideline recommendations exists. Little is known about OA management provided by physiotherapists in Germany and whether treatment aligns with CPGs. The objectives of this study were (1) to investigate the current physiotherapy practice in patients with hip and/or knee OA in Germany, (2) to evaluate physiotherapists' adherence to guideline recommendations and (3) to explore barriers and facilitators to guideline use. Methods A cross-sectional online survey was conducted among physiotherapists. The questionnaire collected information on demographic characteristics, physiotherapists' management of hip and knee OA and the use of CPGs in clinical practice. Guideline adherence was evaluated by comparing the survey findings with guideline recommendations. Full adherence was assumed if all recommended treatment options were chosen. Results In total, 447 (74.9\%) of 597 eligible physiotherapists completed the survey. Data from 442 participants (mean age 41.2 ± 12.8 years; 288 female (65.1\%)) were included in the analysis. The most common treatment choices for both hip and knee OA were exercise therapy (hip OA: 424/442, 95.9\%; knee OA: 426/442, 96.4\%), self-management advice (hip OA: 413/442, 93.2\%; knee OA: 395/442, 89.4\%) and education (hip OA: 325/442, 73.5\%; knee OA: 331/442, 74.9\%), followed by manual therapy (hip OA: 311/442, 70.4\%; knee OA: 311/442, 70.4\%) and joint traction (hip OA: 208/442, 47.1\%; knee OA: 199/442, 45.0\%). Full guideline adherence was found in 17.2\% (76/442) of physiotherapists for hip OA management and in 8.6\% (38/442) for knee OA. Less than half of the respondents (212/430, 49.3\%) were aware of an OA guideline. Conclusions In accordance with current guideline recommendations, most physiotherapists provide exercise therapy and education for patients with hip and/or knee OA. Interventions with low or conflicting evidence were also frequently provided. The limited awareness of existing OA guidelines and the low guideline adherence indicate an insufficient implementation of CPGs in German physiotherapy practice.}, language = {en} } @misc{BahnsSchefflerKopkow, author = {Bahns, Carolin and Scheffler, Bettina and Kopkow, Christian}, title = {Guideline-Adherent Physiotherapy for Patients With Hip and Knee Osteoarthritis in Germany: Protocol for an Implementation Research Project Using the Theoretical Domains Framework and the Behavior Change Wheel}, series = {JMIR Research Protocols}, volume = {12}, journal = {JMIR Research Protocols}, issn = {1929-0748}, doi = {10.2196/47834}, abstract = {Background: Hip and knee osteoarthritis is common and leads to pain, stiffness, and disability. Clinical practice guidelines provide recommendations based on the best available evidence to assist health care professionals and patients in clinical decision-making. However, several studies have reported a gap between guideline recommendations and clinical practice in physiotherapy. Improved implementation strategies and the removal of existing barriers may facilitate the transfer of evidence into clinical practice and contribute to optimized quality of care. Objective: This paper presents the protocol for a study that aims to describe the current physiotherapy practice in patients with hip and knee osteoarthritis and to investigate physiotherapists' adherence to clinical practice guidelines, to identify and specify barriers to and facilitators of guideline use and implementation, and to develop and pilot test a theory-based tailored implementation intervention aiming to increase guideline use in osteoarthritis care. Methods: The research project is divided into 4 parts. During the first part, we will conduct a nationwide web-based survey among German physiotherapists to evaluate the current management of hip and knee osteoarthritis and to evaluate whether treatment aligns with guideline recommendations. Subsequently, semistructured interviews will be conducted to specify barriers to and facilitators of guideline use and implementation among physiotherapists (part 2). On the basis of these findings, in part 3, we will develop a theory-driven implementation intervention based on the Theoretical Domains Framework and the Behavior Change Wheel, which will be evaluated in a controlled pilot study in terms of effectiveness, feasibility, and acceptability (part 4). Results: Data collection of the web-based survey among German physiotherapists (part 1) was completed in December 2021. The semistructured interviews (part 2) were conducted between January and September 2023. Recruitment of physiotherapy practices to participate in the development of the implementation intervention is expected to start in January 2024. Conclusions: This research project aims to develop a theory-driven implementation intervention to facilitate the transfer of evidence from hip and knee osteoarthritis guidelines in physiotherapy practice. We hypothesize that successful implementation will lead to increased guideline adherence in physiotherapists, which in turn will improve the quality of care. The results from our project will provide valuable knowledge concerning the development process and effectiveness of tailored implementation interventions.}, language = {en} } @misc{WeberMuellerBahnsetal., author = {Weber, Franziska and M{\"u}ller, Carsten and Bahns, Carolin and Kopkow, Christian and F{\"a}rber, Francesca and Gellert, Paul and Otte, Ina and Vollmar, Horst Christian and Brannath, Werner and Diederich, Freya and Kloep, Stephan and Rothgang, Heinz and Dieter, Valerie and Krauß, Inga and Kloek, Corelien and Veenhof, Cindy and Collisi, Sandra and Repschl{\"a}ger, Ute and B{\"o}binger, Hannes and Gr{\"u}neberg, Christian and Thiel, Christian and Peschke, Dirk}, title = {Smartphone-assisted training with education for patients with hip and/or knee osteoarthritis (SmArt-E): study protocol for a multicentre pragmatic randomized controlled trial}, series = {BMC Musculoskeletal Disorders}, volume = {24}, journal = {BMC Musculoskeletal Disorders}, number = {1}, doi = {10.1186/s12891-023-06255-7}, abstract = {Hip and knee osteoarthritis are associated with functional limitations, pain and restrictions in quality of life and the ability to work. Furthermore, with growing prevalence, osteoarthritis is increasingly causing (in)direct costs. Guidelines recommend exercise therapy and education as primary treatment strategies. Available options for treatment based on physical activity promotion and lifestyle change are often insufficiently provided and used. In addition, the quality of current exercise programmes often does not meet the changing care needs of older people with comorbidities and exercise adherence is a challenge beyond personal physiotherapy. The main objective of this study is to investigate the short- and long-term (cost-)effectiveness of the SmArt-E programme in people with hip and/or knee osteoarthritis in terms of pain and physical functioning compared to usual care.}, language = {en} } @misc{SpiessBahnsKopkow, author = {Spieß, Pauline and Bahns, Carolin and Kopkow, Christian}, title = {Einstellungen und Adh{\"a}renz zur evidenzbasierten Praxis von in Brandenburg t{\"a}tigen Physiotherapeut*innen}, series = {Physioscience}, volume = {20}, journal = {Physioscience}, number = {1}, issn = {1860-3351}, doi = {10.1055/a-2079-6303}, pages = {22 -- 32}, abstract = {Hintergrund F{\"u}r Deutschland liegen noch unzureichende Daten zur Einstellung und Adh{\"a}renz von Physiotherapeut*innen gegen{\"u}ber Evidenzbasierter Praxis (EBP) vor, insbesondere f{\"u}r im Bundesland Brandenburg t{\"a}tige Physiotherapeut*innen. Ziel Erfassung der 1) Einstellungen und Adh{\"a}renz gegen{\"u}ber EBP von in Brandenburg t{\"a}tigen Physiotherapeut*innen und die 2) Ableitung von Barrieren und F{\"o}rderfaktoren f{\"u}r die Einhaltung der EBP. Methodik Von M{\"a}rz bis April 2022 wurde eine Online-Befragung unter in Brandenburg t{\"a}tigen Physiotherapeut*innen durchgef{\"u}hrt. Die Teilnehmenden f{\"u}llten die deutschsprachige Version des „Evidence-based Practice Inventory" aus, einem Fragebogen mit 5 Dimensionen zur Erfassung von Barrieren und F{\"o}rderfaktoren hinsichtlich EBP. Zus{\"a}tzlich wurden soziodemografische Daten erfragt. Die Auswertung erfolgte deskriptiv. Ergebnisse Es nahmen 101 Physiotherapeut*innen an der Befragung teil, davon 75 (74 \%) Frauen und 26 (26 \%) M{\"a}nner. Die Befragten waren im Durchschnitt 39 Jahre (± 13) alt und verf{\"u}gten {\"u}ber eine Berufserfahrung von 16 Jahren (± 12). Mehr als 70 \% der Teilnehmenden hatten eine positive Einstellung gegen{\"u}ber EBP. Knapp 55 \% der Physiotherapeut*innen f{\"u}hlten sich in der Lage, Prinzipien der EBP in ihren klinischen Entscheidungen anzuwenden. Gleichzeitig gaben weniger als 20 \% an, dass in ihrer Abteilung sehr darauf geachtet wird, Prinzipien der EBP in klinischen Entscheidungen anzuwenden. Im Durchschnitt wiesen 30 \% der Befragten eine hohe EBP-Adh{\"a}renz in den 5 Dimensionen auf. Die wichtigsten F{\"o}rderfaktoren f{\"u}r Adh{\"a}renz zur EBP bildeten die Autor*innenschaft oder Mitarbeit an wissenschaftlichen Ver{\"o}ffentlichungen und die Teilnahme an einem Kurs zur EBP. Schlussfolgerung Die Einstellung von in Brandenburg t{\"a}tigen Physiotherapeut*innen gegen{\"u}ber EBP ist grundlegend positiv. Es zeigte sich jedoch, dass die Adh{\"a}renz zur EBP nur bei einem geringeren Anteil der Physiotherapeut*innen stark ausgepr{\"a}gt ist. Barrieren und F{\"o}rderfaktoren sollten n{\"a}her untersucht werden, um zielgerichtete Interventionen zu entwickeln und die Implementierung von EBP im klinischen Alltag zu verbessern.}, language = {de} } @misc{BraunThielZilleretal., author = {Braun, Tobias and Thiel, Christian and Ziller, Carina and Rasche, Julia and Bahns, Carolin and Happe, Lisa and Retzmann, Theresa and Gr{\"u}neberg, Christian}, title = {Prevalence of frailty in older adults in outpatient physiotherapy in an urban region in the western part of Germany : a cross-sectional study}, series = {BMJ Open}, volume = {9}, journal = {BMJ Open}, number = {6}, issn = {2044-6055}, doi = {10.1136/bmjopen-2018-027768}, pages = {14}, language = {en} }