Patient Values and Preferences
A patient with a prescription of exercises to treat idiopathic lower back pain consults a physiotherapist.
The patient has assumed he was only going to receive massages and passive mobilisation, but the physiotherapist – based on recommendations to make exercise a priority – offers a programme of active, progressive exercises designed to alleviate the patient’s lower back pain.
As the patient is reluctant to move, the physiotherapist explains the impact that an overly sedentary lifestyle could have on his pain.
The physiotherapist understands that the patient needs up-to-date information on the management of lower back pain to motivate him to adhere to the treatment. He refers him to reliable sources of information for patients so that he can read up on this, and offers to see him again to talk it over.
At the second appointment, the patient, who has taken the time to educate himself, feels more motivated to move actively.
Going forward, they agree together on a programme combining active exercises to do at the physiotherapist’s practice and at home, as well as some appropriate adjuvant massages and mobilisations.
EPB is not limited to an examination of the evidence: it is an approach that provides healthcare professionals with a useful framework for deciding on the most appropriate action for a given patient based on current best practices.
This approach involves several stages: asking a question, accessing evidence, assessing it, applying it by adapting it according to the expertise, the patient’s values and the context, and verifying the results.
In concrete terms, applying the EBP approach means a practitioner will follow a five-step method:
A- ASK: formulate the problem into a clinical question
A- ACQUIRE: effectively search for the best evidence that can usefully answer this question
A- APPRAISE: assess the methodological quality and applicability of the evidence found in its own real-life situation
A- APPLY: make a decision based on the available evidence, the patient’s preferences, wishes and expectations, as well as the practitioner’s own knowledge, experience and context.
A – ASSESS: assess the results following the adoption of this EBP approach