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Invited Commentary
February 8, 2010

Adherence, Not Just for PatientsComment on “Low Back Pain and Best Practice Care”

Author Affiliations

Author Affiliation: Division of General Pediatrics, University of California, San Francisco, School of Medicine.

Arch Intern Med. 2010;170(3):277-278. doi:10.1001/archinternmed.2009.478

Despite good intentions, patients do not always follow “doctor's orders.” It turns out that physicians are not much better, at least when it comes to adherence to clinical practice guidelines.

Williams and coauthors present another compelling example. They analyzed 3533 patient visits to Australian general practitioners during the 3 years before and the 3 years after the publication of a clinical practice guideline for the treatment of low back pain.1 The introduction of a local, evidence-based clinical practice guideline had no effect on physician treatment of low back pain as measured by the frequency of patient counseling, prescription of analgesics, and use of imaging.

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