American College Of Occupational And Environmental Medicine Issues Practice Guidelines Update
Elk Grove Village, IL - Injured workers will receive improved health care for their elbow problems due to the release of an extensive update of its evidence-based practice guidelines by the American College of Occupational and Environmental Medicine (ACOEM). The section on elbow conditions updates ACOEM's Occupational Medicine Practice Guidelines: Evaluation and Management of Common Health Problems and Functional Recovery in Workers, 2nd Ed., currently in wide-spread use across the country.
A critical tool for physicians, health care professionals, and others who have responsibility for workers' compensation patients, the Guidelines lay the groundwork for effective treatment of occupational injuries and returning patients to function/work, and were created to improve the medical diagnoses of workplace-related injuries and diseases, enhance the effectiveness of treatment, and help occupational and environmental physicians manage growing caseloads. The treatment approach is intended to optimize the employee's recovery. "The ACOEM Guidelines are truly state-of-the-art and will assist physicians and workers to obtain the most successful treatment options available, thereby speeding patient recovery from these common musculoskeletal disorders," said editor-in-chief Kurt T. Hegmann, MD, MPH.
The revised elbow chapter contains the following enhancements:
- Detailed recommendations regarding the use of orthotics, exercise, heat/cold packs, iontophoresis, ultrasound, manipulation, massage, friction massage, soft tissue mobilization, biofeedback, transcutaneous electrical nerve stimulation, electrical stimulation, magnets, diathermy, extracorporeal shockwave therapy, phonophoresis, low level laser therapy, and acupuncture used to treat tennis elbow (lateral epicondylitis).
- A more detailed physical examination section to improve diagnostic accuracy.
- A thorough review of surgical procedures on the elbow.
- Inclusion of numerous disorders including biceps tendinosis, pronator syndrome, dislocation, and sprains.
- An in-depth review of medications used to treat elbow conditions including acetaminophen, oral and topical NSAIDs, aspirin, narcotics, corticosteroid injections, and botulinum injections.
A crucial part of the updating process was ACOEM's adoption of a new more meticulous strength-of-evidence rating methodology. The enhanced methodology incorporates the highest scientific standards for reviewing evidence-based literature, thus ensuring the most rigorous, reproducible, and transparent occupational health guidelines available. As a result, the updated chapter contains an even more extensive list of references - 122 versus 28 in the previous version. "Being the premier occupational medical association dedicated to worker health and safety, ACOEM is committed to excellence in health care. Our Guidelines, which have been continually judged the best available, result in better patient outcomes without wasting valuable resources," said ACOEM President Robert K. McLellan, MD, MPH. "In short, the ACOEM Guidelines help assure that workers receive the right care, at the right time, every time."
The ACOEM Guidelines have been adopted by the states of California and Nevada. In California, they were adopted by statute in 2004 as the standard for appropriate care. The Guidelines were recommended by the RAND Corporation to California's Commission on Health and Safety and Workers' Compensation as the best medical treatment guideline available, and the California Division of Workers' Compensation (DWC) used that recommendation in considering its medical treatment guideline regulations. "Using the ACOEM Guidelines has brought evidence-based medicine to California's workers' compensation system," said DWC Executive Medical Director Dr. Anne Searcy. "They've helped reduce over-utilization of ineffective treatments, which has led to more positive outcomes for injured workers and employers." The California DWC has incorporated the Guidelines, along with ACOEM's new methodology, into its proposal for a permanent medical treatment utilization schedule.
SOURCE: ACOEM