Has the quality of physiotherapy care in patients with Whiplash-associated disorders (WAD) improved over time? A retrospective study using routinely collected data and quality indicators.

Autor: Oostendorp RA; Scientific Institute for Quality of Healthcare, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands, oostendorp.rob@gmail.com.; Department of Manual Therapy, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium, oostendorp.rob@gmail.com.; Pain in Motion International Research Group, Free University Brussels, Brussels, Belgium, oostendorp.rob@gmail.com.; Practice Physiotherapy and Manual Therapy, Heeswijk-Dinther, the Netherlands, oostendorp.rob@gmail.com., Elvers H; Department of Public Health and Research, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands.; Methodological Health-Skilled Institute, Beuningen, the Netherlands., van Trijffel E; SOMT University of Physiotherapy, Amersfoort, the Netherlands.; Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Free University Brussels, Brussels, Belgium., Rutten GM; Institute of Health Studies, Faculty of Health and Social Studies, HAN University of Applied Science, Nijmegen, the Netherlands.; Faculty of Science and Engineering, University College Venlo, Maastricht University, Maastricht, the Netherlands., Scholten-Peeters GG; Department of Human Movement Sciences, Faculty of Behavioral and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands., Heijmans M; Practice Physiotherapy and Manual Therapy, Heeswijk-Dinther, the Netherlands, oostendorp.rob@gmail.com., Hendriks E; Department of Epidemiology, Center of Evidence-Based Physiotherapy, Maastricht University, Maastricht, the Netherlands.; Practice Physiotherapy 'Klepperheide', Druten, the Netherlands., Mikolajewska E; Department of Physiotherapy, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Toruń, Poland.; Neurocognitive Laboratory, Centre for Modern Interdisciplinary Technologies, Nicolaus Copernicus University, Toruń, Poland., De Kooning M; Pain in Motion International Research Group, Free University Brussels, Brussels, Belgium, oostendorp.rob@gmail.com.; Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Free University Brussels, Brussels, Belgium.; Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Brussels, Belgium., Laekeman M; Department of Nursing Sciences, Faculty of Health, University Witten/Herdecke, Witten, Germany., Nijs J; Pain in Motion International Research Group, Free University Brussels, Brussels, Belgium, oostendorp.rob@gmail.com.; Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Free University Brussels, Brussels, Belgium.; Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Brussels, Belgium., Roussel N; Department of Rehabilitation Sciences and Physiotherapy (MOVANT), Faculty of Medicine and Health Sciences, University of Antwerp, Belgium., Samwel H; Department of Medical Psychology, Canisius Wilhelmina Hospital, Nijmegen, the Netherlands.
Jazyk: angličtina
Zdroj: Patient preference and adherence [Patient Prefer Adherence] 2018 Nov 08; Vol. 12, pp. 2291-2308. Date of Electronic Publication: 2018 Nov 08 (Print Publication: 2018).
DOI: 10.2147/PPA.S179808
Abstrakt: Purpose: To develop valid quality indicators (QIs) for physiotherapy care based on best available evidence, and to use these QIs to explore trends in the quality of physiotherapy care of patients with Whiplash-associated disorders (WAD) using guideline-based routinely collected data (RCD) gathered between 1996 and 2011.
Materials and Methods: The study consisted of two phases: 1) development of QIs and 2) analysis of patient records. A set of QIs was developed based on recommendations in the scientific literature and the Dutch Clinical Practice Guideline (CPG) "Physiotherapy Management and WAD". QIs were expressed as percentages, allowing target performance levels to be defined (≥80% or ≤30% depending on whether desired performance required a high or low score on a QI). We then analyzed WAD patient data (N = 810) collected over a period of 16 years in two physiotherapy practices, separating patients into two groups defined as before (Group A 1996-2002; n = 353) and after (Group B 2003-2011; n = 457) implementation and transition to the Dutch CPG "Physiotherapy Management and WAD".
Results: Using an iterative process and input from both experts and users, 28 QIs were developed and subsequently classified per step of the clinical reasoning process for physiotherapy care. Based on 16 years of RCD, we found that the clinical reasoning process differed significantly ( P ≤ 0.05) between the groups, in favor of Group B. Twelve of the 25 indicators (48.0%) in Group A and 19 of 26 indicators (73.1%) in Group B met predetermined performance targets. The number of target indicators also differed significantly between groups, favoring Group B ( P ≤ 0.05).
Conclusion: A preliminary set of novel QIs was developed. Using RCD and these QIs, we conclude that physiotherapy care in our study setting improved over the period 1996-2011. Furthermore, the QIs met the performance targets set for the clinical reasoning process after the transition to the Dutch CPG "Physiotherapy Management and WAD".
Competing Interests: Disclosure The authors report no conflicts of interest in this work.
Databáze: MEDLINE
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