H11Implementing physiotherapy Huntington's disease guidelines in clinical practice: a global survey

Background Clinical practice guidelines are often not optimally translated to clinical care. Following the publication of the Huntington’s disease (HD) physiotherapy clinical practice guidelines in 2020, the European Huntington’s Disease Network Physiotherapy Working Group (EHDN PWG) identified a need to explore perceived facilitators and barriers to their implementation. The aims of this study were to explore physiotherapists’ awareness of and perceived barriers and facilitators to implementation of the 2020 guidelines. Methods An observational study was carried out using an online survey. Participants were physiotherapists recruited via the EHDN and physiotherapy associations in the United Kingdom, Australia, and United States of America. The survey gathered data on agreement and disagreement with statements of barriers and facilitators to implementation of each of six recommendations in the guidelines using Likert scales. Results There were 32 respondents: 18 from Europe, 7 from Australia, 5 from the USA, 1 from Africa (1 missing data). The majority were aware of the guidelines (69%), with 75% working with clients with HD < 40% of their time. Key findings were that HD specific attributes (physical, behavioural and low motivation) were perceived to be barriers to implementation of recommendations ( ≥ 70% agreement). Support from colleagues (81-91% agreement), an individualised plan (72-88% agreement) and physiotherapists’ expertise in HD (81-91% agreement) were found to be facilitators of implementation in all six of the recommendations. Conclusions This study is the first to explore implementation of guidelines in physiotherapy clinical practice. Resources from PWG to support physiotherapists need to focus on ways to implement recommendations specifically related to management of physical, behavioural and motivational problems associated with HD. This would enhance physiotherapists’ expertise, a facilitator to implementation of clinical practice guidelines