Best Practice in the management of Whiplash Associated Disorders

Best Practice in the management of

Whiplash Associated Disorders

Dr Saravana KumarDr Saravana Kumar

NHMRC NICS TRACsa MAC FellowNHMRC NICS TRACsa MAC Fellow

Acknowledgements

• This Fellowship is sponsored by– National Health and Medical Research

Council – National Institute of Clinical Studies

– Motor Accident Commission and TRACsa

Aim of the presentation• To take you on a journey through

– The theme of my research– My research process– The impact of my research

Health care in Australia

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Driving

Bungee jumping

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Chemical Manufacturing

Chartered Flights

Scheduled Airlines

European RailroadsNuclearPower

Health Care in AustraliaHealth Care in Australia• Challenges facing health care

– Increasingly ageing population– Increasing co-morbidities– Increasing pressures on health care

resources• Minimising wastage

– Increasing need for quality in health care• Patient being an active participant

– Chronic shortage of health professionals

Drastic changes to health careDrastic changes to health care

• Quality in health care– Increasing need for accountability

• Quality in health care underpinned by safety, effectiveness, patient centeredness, timeliness, equity and efficiency

• Evidence Based Practice– Integrating research evidence with

clinical expertise and patient values

Quality of health care

• My research– Improving physiotherapy and chiropractic

management of whiplash

• What is whiplash?

Whiplash and its management

• Whiplash Associated Disorders (WAD) accounts for 42% of compulsory third party insurance claims

• 14-42% with whiplash develop long term complaints with 10% in constant severe pain

• Complexities in management of WAD– Structures involved– Patients expectations– Compensation system

Management of WAD• Physiotherapists and Chiropractors

– Crucial role, especially in the early stages– However

• conflicting evidence for many commonly used interventions & evidence-practice gap

Clinical guidelines for WAD• Development of a new clinical guideline

(TRACsa WAD guideline)• This project is about implementing this guideline

to address the evidence-practice gap

Implementation of TRACsa guideline

• Evidence on successful implementation strategies for practitioners– Multi-dimensional strategies– Recognising barriers and enablers– Support and recognition– Intention-behaviour gap and stages/domains

of behaviour change

• Involvement of consumers– Active participant and act as drivers for

change

Outcomes from this research• Unique and world first

– Physiotherapy and chiropractics together– Active involvement of consumers– Bridging gap between research evidence and

clinical practice• Implementation science

– Cutting edge research on understanding behaviour change

Insanity: doing the same thing over and over again and expecting different results.

– Albert Einstein