Special Interest Report
Population: Adult
Kirsten Potter, PT, DPT, MS, Associate Professor, Rockhurst University kirsten.potter@rockhurst.edu
Jennifer Moore, PT, DHS, NCS, Advisor, South-Eastern Norway Regional Center for Knowledge Translation, Oslo, Norway jennimoorept1@gmail.com
Kathleen Blankshain, DPT, Physical Therapist, Athletico kathleenblankshain2011@u.northwestern.edu
Sandra Kaplan, PT, DPT, PhD, Professor, Rutgers – The State University of New Jersey kaplans@shrp.rutgers.edu
Jane Sullivan, PT, DHS, MS, Associate Professor, Northwestern University j-sullivan@northwestern.edu
Keywords: Plasticity, Outcome measurement, Clinical Practice Guideline
Introduction: The American Physical Therapy Association (APTA) supports the development of evidence-based Clinical Practice Guidelines (CPG). Knowledge translation frameworks and international guideline criteria advocate for the inclusion of relevant stakeholders in CPG development. One approach that CPG developers can use is to recruit an expert panel, inclusive of patients, clinicians, and content experts, to inform the scope of the CPG. If the panels are small in number, their suggestions may not be generalizable. To ensure that a CPG is useful to patients, families, and clinicians, it is critical to include greater numbers of stakeholders in the CPG development process in a cost-efficient manner.
Purpose: This project’s purpose was to broadly identify the needs of two primary stakeholder groups, patients and clinicians, to inform the scope of a CPG on a core set of outcome measures (OMs) for neurologic physical therapy (PT) practice.
Description: We surveyed patients and members of the APTA Neurology Section. Patients were surveyed about their reasons for seeking PT, their goals for therapy, and the relevance of OMs to their care. Clinicians were surveyed about the types of OMs that should be included in the core set, common constructs assessed via OMs, and clinical utility factors that impact OM use in practice.
Summary of Use: 215 patients and 174 clinicians completed surveys. The main patient diagnoses were multiple sclerosis (49%), stroke (34%), and spinal cord injury (14%). Patients were most often referred to PT for gait (83%) and balance (68%). Clinicians “often” or “sometimes” used measures of activity (98%), body function/structure (81%), and participation (71%). Clinicians indicated it is essential to include measures of balance, gait, patient-stated goals, and transfers in the core set. Patients reported that it was most important to improve in balance and gait. This data from patients and clinicians clearly agrees that balance, gait, transfers, and patient-stated goals are important and should be included in the OM core set.
Importance to Members: Our surveys provided feedback from a broad group of stakeholders, and serves to validate the topics of OMs to address in the CPG. Guideline developers should consider engaging patients and clinicians to obtain feedback early in the process. Doing so may expedite meaningful knowledge translation to clinical practice.
Citation:
Potter, Kirsten , PT, DPT, MS; Moore, Jennifer , PT, DHS, NCS; Blankshain, Kathleen , DPT; Kaplan, Sandra L, PT, DPT, PhD; Sullivan, Jane E, PT, DHS, MS. Patient, Caregiver, and Clinician Participation to Focus the Scope of a Clinical Practice Guideline: A Paradigm Shift.. Poster Presentation. IV STEP Conference, American Physical Therapy Association, Columbus, OH, July 17, 2016. Online. https://u.osu.edu/ivstep/poster/abstracts/012_potter-et-al/