David Spitaels1, Rosella Hermens2, Dieter Van Assche3, Sabine Verschueren4, Frank Luyten5, Patrik Vankrunkelsven6. 1. Academic Center for General Practice, KU Leuven, Kapucijnenvoer 33 blok J, 3000 Leuven, Belgium. Electronic address: david.spitaels@kuleuven.be. 2. Academic Center for General Practice, KU Leuven, Kapucijnenvoer 33 blok J, 3000 Leuven, Belgium; IQ Healthcare, Radboud University Medical Center Nijmegen, PO Box 9101, 6500 HB Nijmegen, The Netherlands. Electronic address: rosella.hermens@radboudumc.nl. 3. Division of Rheumatology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium; Department of Rehabilitation Sciences, KU Leuven, Tervuursevest 101, 3001 Heverlee, Belgium. Electronic address: dieter.vanassche@uzleuven.be. 4. Department of Rehabilitation Sciences, KU Leuven, Tervuursevest 101, 3001 Heverlee, Belgium. Electronic address: sabine.verschueren@kuleuven.be. 5. Division of Rheumatology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium. Electronic address: frank.luyten@uzleuven.be. 6. Academic Center for General Practice, KU Leuven, Kapucijnenvoer 33 blok J, 3000 Leuven, Belgium. Electronic address: patrik.vankrunkelsven@kuleuven.be.
Abstract
BACKGROUND: Osteoarthritis (OA) is a common musculoskeletal condition that often leads to pain, stiffness and disability. Physiotherapy plays an important role in the management of knee OA, however we hypothesize discordance between physiotherapists' practice and existing guideline recommendations. OBJECTIVES: This study aimed to measure physiotherapists' guideline adherence for knee OA. Additionally, determinants for guideline adherence at the professional and organizational level were explored, to find clues for improvement. METHOD: A survey was performed among Belgian physiotherapists. Guideline adherence was measured with a set of 9 quality indicators, developed for the Belgian primary healthcare system, applicable for physiotherapists and extracted from evidence-based guidelines. Treatment modalities that do not contribute to high quality care were also examined. RESULTS: 284 Physiotherapists responded to the survey. Compliance to the quality indicators varied between 27% and 98%. Quality indicator compliance above 80% was found for: education on the importance of exercise, delivering functional and strength exercise therapy, patient tailored exercise program, instruction of patients in appropriate exercises and referral for sports activities after therapy. Quality indicator compliance less than 50% was found for: education on the importance of weight loss, providing self-management strategies, spreading treatment session over longer periods and regular evaluations of the exercise therapy. For treatment modalities that do not contribute to high quality care, massage (49%) and cold application (24%) were most frequently applied. CONCLUSIONS: This study showed large variations in adherence to quality indicators in OA management by physiotherapists. Improvement strategies should focus on quality indicators related to long-term treatment options.
BACKGROUND:Osteoarthritis (OA) is a common musculoskeletal condition that often leads to pain, stiffness and disability. Physiotherapy plays an important role in the management of knee OA, however we hypothesize discordance between physiotherapists' practice and existing guideline recommendations. OBJECTIVES: This study aimed to measure physiotherapists' guideline adherence for knee OA. Additionally, determinants for guideline adherence at the professional and organizational level were explored, to find clues for improvement. METHOD: A survey was performed among Belgian physiotherapists. Guideline adherence was measured with a set of 9 quality indicators, developed for the Belgian primary healthcare system, applicable for physiotherapists and extracted from evidence-based guidelines. Treatment modalities that do not contribute to high quality care were also examined. RESULTS: 284 Physiotherapists responded to the survey. Compliance to the quality indicators varied between 27% and 98%. Quality indicator compliance above 80% was found for: education on the importance of exercise, delivering functional and strength exercise therapy, patient tailored exercise program, instruction of patients in appropriate exercises and referral for sports activities after therapy. Quality indicator compliance less than 50% was found for: education on the importance of weight loss, providing self-management strategies, spreading treatment session over longer periods and regular evaluations of the exercise therapy. For treatment modalities that do not contribute to high quality care, massage (49%) and cold application (24%) were most frequently applied. CONCLUSIONS: This study showed large variations in adherence to quality indicators in OA management by physiotherapists. Improvement strategies should focus on quality indicators related to long-term treatment options.
Authors: van Melick N; Hoogeboom Tj; Pronk Y; Rutten B; van Tienen Tg; Nijhuis-van der Sanden Mwg; van Cingel Reh Journal: Int J Sports Phys Ther Date: 2020-12
Authors: George E Fragoulis; Lisa Edelaar; Theodora P M Vliet Vlieland; Annamaria Iagnocco; Valentin Sebastian Schäfer; Catherine Haines; Jan Schoones; Elena Nikiphorou Journal: RMD Open Date: 2019-10-23
Authors: Simon Majormoen Bruhn; Lina Holm Ingelsrud; Thomas Bandholm; Søren Thorgaard Skou; Henrik M Schroder; Susanne Reventlow; Anne Møller; Jakob Kjellberg; Thomas Kallemose; Anders Troelsen Journal: BMJ Open Date: 2021-07-07 Impact factor: 2.692
Authors: Rob A B Oostendorp; J W Hans Elvers; Emiel van Trijffel; Geert M Rutten; Gwendolyne G M Scholten-Peeters; Marcel Heijmans; Erik Hendriks; Emilia Mikolajewska; Margot De Kooning; Marjan Laekeman; Jo Nijs; Nathalie Roussel; Han Samwel Journal: Patient Prefer Adherence Date: 2020-03-02 Impact factor: 2.711