Strategies to revise the Korean Medicine Clinical Practice Guideline for lumbar herniated intervertebral disc-A web based approach

Introduction: Lumbar herniated intervertebral disc (LHIVD) is a common musculoskeletal disorder and in Korea, affected patients often consult traditional Korean Medicine (TKM) practitioners. The 'Korean Medicine Clinical Practice Guideline (KM-CPG) for LHIVD' was developed in 2015 to help the evidence-based decision-making of clinical practitioners and patients. The aim of this study was to investigate opinions of TKM doctors on the KM-CPG for LHIVD and whether it had been implemented in order to use this information to establish a strategy for revision. Metnods: A questionnaire was developed consisting of 17 items which included: demographic characteristics; awareness, utilization status, and directions to improve of the KM-CPG for LHIVD; and clinical treatment status. The questionnaire was sent via e-mail to 18,334 TKM doctors. Results: A total of 373 respondents answered the questionnaire, of whom 95.4 % were clinical practitioners. 258 respondents (69.2 %) did not recognize the KM-CPG for LHIVD, and reported they had been unaware of the guideline due to lack of publicity (n = 236, 63.3 %) and this was the most frequent response regarding why this had been an obstacle to its use. Of the 115 participants who knew the guideline existed, 40.9 % gave a negative answer about its actual utilization in clinical practice. The main recommendations for improvement of the KM-CPG by respondents were to: include recommendations on diagnosis and prognosis, identify excluded interventions, and refine or upgrade recommendations through evidence-based research. Conclusion: In order to develop KM-CPG for LHIVD with high utilization, it is necessary to conduct clinical research for producing the evidence that could supplement previous recommendations, as well as raising awareness through a dissemination strategy.