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10 - Conclusions and future developments
In conclusion, it may be stated that the first two of the objectives identified in section 3 have been achieved. A guidelines document has been developed, and the biological bases, empirical evidence and consensus view has been provided to support the guideline statements. From this definitive document, which may be used as a reference text, alternative modes of presentation will be developed to target the identified populations, in order to achieve the third objective.
Following dissemination of the guidelines in appropriate format to the target populations, the degree of implementation of the guidelines will be evaluated through audit. This will document the flow of information to the practitioners, and the degree to which the guidelines have been incorporated in current practice.
As an intervention, PRICE, as a total package and in terms of its individual components, is cheap and readily available. It is simple to apply, and if correct advice is given, does not require the presence of an experienced practitioner. These guidelines, and the summary documents to be developed for wider dissemination, will provide the best evidence-based advice for both practitioner and patients. However, in view of the surprisingly limited amount of evidence in the literature to support definitive guidelines for the application of the PRICE regimen, it is apparent that further research is necessary to provide that evidence. Thus, there will be a need to review these guidelines as further evidence becomes available.
10.1 - Review of the guidelines
It is proposed that these guidelines should be reviewed in three years, when it is hoped that new evidence on the mode of application of PRICE will have emerged. To ensure continuity, and also with a view to taking these guidlines forward, it is suggested that the review panel should consist of the present development group, with additional members from the current (at the time of review) committee of ACPSM - the Chair, Vice-Chair and Education Chair. End-users will be included where appropriate.
10.2 - Monitoring of guidelines
Because of the potential scope of these guidelines, conventional methods of monitoring compliance through clinic attendance, assessment, goal attainment etc may not possible. The process of auditing the guidelines might take the following suggestions into consideration.
| 1 | Monitoring the dissemination of the guidelines reference document - this will be distributed to all ACPSM members, to all academic physiotherapy departments, and to regional Sports Councils. Already we have had requests for the document from several other interested par-ties. A record will be kept of the distribution. |
| 2 | Monitoring the distribution of the summary leaflets. |
| 3 | A follow-up questionnaire to members of ACPSM to determine what impact the guidelines have had on clinical practice. |
| 4 | Targeting specific athlete/patient/user groups to determine if they have received leaflets / advice on the immediate management of their soft tissue injuries, and how closely their practice of PRICE conforms to the guidelines. |