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Patient-Reported Outcome–Based Quality Indicators in Dutch Primary Care Physical Therapy for Patients With Nonspecific Low Back Pain: A Cohort Study

OBJECTIVE: The purpose of this study was to define and select a core set of outcome-based quality indicators, accepted by stakeholders on usability and perceived added value as a quality improvement tool, and to formulate recommendations for the next implementation step. METHODS: In phase 1, 15 pote...

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Autores principales: Verburg, Arie C, van Dulmen, Simone A, Kiers, Henri, Nijhuis-van der Sanden, Maria W G, van der Wees, Philip J
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8336590/
https://www.ncbi.nlm.nih.gov/pubmed/33929546
http://dx.doi.org/10.1093/ptj/pzab118
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author Verburg, Arie C
van Dulmen, Simone A
Kiers, Henri
Nijhuis-van der Sanden, Maria W G
van der Wees, Philip J
author_facet Verburg, Arie C
van Dulmen, Simone A
Kiers, Henri
Nijhuis-van der Sanden, Maria W G
van der Wees, Philip J
author_sort Verburg, Arie C
collection PubMed
description OBJECTIVE: The purpose of this study was to define and select a core set of outcome-based quality indicators, accepted by stakeholders on usability and perceived added value as a quality improvement tool, and to formulate recommendations for the next implementation step. METHODS: In phase 1, 15 potential quality indicators were defined for patient-reported outcome measures and associated domains, namely the Numeric Pain Rating Scale (NPRS) for pain intensity, the Patient Specific Functioning Scale (PSFS) for physical activity, the Quebec Back Pain Disability Scale for physical functioning, and the Global Perceived Effect—Dutch Version for perceived effect. Their comparability and discriminatory characteristics were described using cohort data. In phase 2, a core set of quality indicators was selected based on consensus among stakeholders in focus group meetings. RESULTS: In total, 65,815 completed treatment episodes for patients with nonspecific low back pain were provided by 1009 physical therapists from 219 physical therapist practices. The discriminability between physical therapists of all potential 15 quality indicators was adequate, with intraclass correlation coefficients between 0.08 and 0.30. Stakeholders selected a final core set of 6 quality indicators: 2 process indicators (the routine measurement of NPRS and the PSFS) and 4 outcome indicators (pretreatment and posttreatment change scores for the NPRS, PSFS, Quebec Back Pain Disability Scale, and the minimal clinically important difference of the Global Perceived Effect—Dutch Version). CONCLUSION: This study described and selected a core set of outcome-based quality indicators for physical therapy in patients with nonspecific low back pain. The set was accepted by stakeholders for having added value for daily practice in physical therapy primary care and was found useful for quality improvement initiatives. Further studies need to focus on improvement of using the core set of outcome-based quality indicators as a quality monitoring and evaluation instrument. IMPACT: Patient-reported outcome–based quality indicators developed from routinely collected clinical data are promising for use in quality improvement in daily practice.
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spelling pubmed-83365902021-08-09 Patient-Reported Outcome–Based Quality Indicators in Dutch Primary Care Physical Therapy for Patients With Nonspecific Low Back Pain: A Cohort Study Verburg, Arie C van Dulmen, Simone A Kiers, Henri Nijhuis-van der Sanden, Maria W G van der Wees, Philip J Phys Ther Original Research OBJECTIVE: The purpose of this study was to define and select a core set of outcome-based quality indicators, accepted by stakeholders on usability and perceived added value as a quality improvement tool, and to formulate recommendations for the next implementation step. METHODS: In phase 1, 15 potential quality indicators were defined for patient-reported outcome measures and associated domains, namely the Numeric Pain Rating Scale (NPRS) for pain intensity, the Patient Specific Functioning Scale (PSFS) for physical activity, the Quebec Back Pain Disability Scale for physical functioning, and the Global Perceived Effect—Dutch Version for perceived effect. Their comparability and discriminatory characteristics were described using cohort data. In phase 2, a core set of quality indicators was selected based on consensus among stakeholders in focus group meetings. RESULTS: In total, 65,815 completed treatment episodes for patients with nonspecific low back pain were provided by 1009 physical therapists from 219 physical therapist practices. The discriminability between physical therapists of all potential 15 quality indicators was adequate, with intraclass correlation coefficients between 0.08 and 0.30. Stakeholders selected a final core set of 6 quality indicators: 2 process indicators (the routine measurement of NPRS and the PSFS) and 4 outcome indicators (pretreatment and posttreatment change scores for the NPRS, PSFS, Quebec Back Pain Disability Scale, and the minimal clinically important difference of the Global Perceived Effect—Dutch Version). CONCLUSION: This study described and selected a core set of outcome-based quality indicators for physical therapy in patients with nonspecific low back pain. The set was accepted by stakeholders for having added value for daily practice in physical therapy primary care and was found useful for quality improvement initiatives. Further studies need to focus on improvement of using the core set of outcome-based quality indicators as a quality monitoring and evaluation instrument. IMPACT: Patient-reported outcome–based quality indicators developed from routinely collected clinical data are promising for use in quality improvement in daily practice. Oxford University Press 2021-04-30 /pmc/articles/PMC8336590/ /pubmed/33929546 http://dx.doi.org/10.1093/ptj/pzab118 Text en © The Author(s) 2021. Published by Oxford University Press on behalf of the American Physical Therapy Association. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Original Research
Verburg, Arie C
van Dulmen, Simone A
Kiers, Henri
Nijhuis-van der Sanden, Maria W G
van der Wees, Philip J
Patient-Reported Outcome–Based Quality Indicators in Dutch Primary Care Physical Therapy for Patients With Nonspecific Low Back Pain: A Cohort Study
title Patient-Reported Outcome–Based Quality Indicators in Dutch Primary Care Physical Therapy for Patients With Nonspecific Low Back Pain: A Cohort Study
title_full Patient-Reported Outcome–Based Quality Indicators in Dutch Primary Care Physical Therapy for Patients With Nonspecific Low Back Pain: A Cohort Study
title_fullStr Patient-Reported Outcome–Based Quality Indicators in Dutch Primary Care Physical Therapy for Patients With Nonspecific Low Back Pain: A Cohort Study
title_full_unstemmed Patient-Reported Outcome–Based Quality Indicators in Dutch Primary Care Physical Therapy for Patients With Nonspecific Low Back Pain: A Cohort Study
title_short Patient-Reported Outcome–Based Quality Indicators in Dutch Primary Care Physical Therapy for Patients With Nonspecific Low Back Pain: A Cohort Study
title_sort patient-reported outcome–based quality indicators in dutch primary care physical therapy for patients with nonspecific low back pain: a cohort study
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8336590/
https://www.ncbi.nlm.nih.gov/pubmed/33929546
http://dx.doi.org/10.1093/ptj/pzab118
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