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Verburg AC1, van Dulmen SA1, Kiers H2, Nijhuis-van der Sanden MWG1, van der Wees PJ1
1Radboud Institute for Health Sciences, IQ Healthcare, Nijmegen, Netherlands, 2Hogeschool Utrecht, Physiotherapy, Utrecht, Netherlands
Background: The outcomes of the patients health after a physical therapy treatment can be measured wit patient reported outcome measures (PROMs). Using such combined outcomes in the evaluation of quality of care is proposed to facilitate the interaction between patient and healthcare professional, including the process of shared decision making, goal setting, and evaluation of treatment effects.These outcome sets can also be used for transparency purposes, e.g. for patients to choose a provider organization and for insurance companies to pay for performance purposes. For successful implementation of such outcome set, patients and healthcare professionals need to accept it as having added value in daily practice. In previous studies, several outcome sets for nonspecific low back pain are developed, mainly in clinical trial purposes. However, these outcome sets are not tested on relevance and feasibility in the evaluation of quality of care in daily practice.
Purpose: To develop a clinical core set of outcome measures that is accepted for relevance, feasibility and validity by stakeholders and useful for a) interaction between patient and professional, b) internal quality improvement, and c) external transparency in patients with NSLBP in primary care physical therapy.
Methods: We used a consensus-driven modified RAND-UCLA Delphi technique. In total we conducted seven separate steps with panellists (physical therapists, patient representatives, health insurers) to select accepted outcomes. These seven steps consisted of a literature search, two online surveys, patient interviews, an experts meeting, a consensus meeting and final approval of an advisory board. Results of previous steps were discussed during the consensus meeting, and then panellists voted for inclusion per measure. In the last online survey the final core set were rated on relevance en feasibility on a 9 point Likert scale, when the median was ≥7 the core sets was accepted.
Results: 34 panellists in two online surveys, five panellists in an expert committee, ten patients for semi-structured interviews and 26 panellists in a consensus meeting participated in the study. In total 12 outcome measures were rated and discussed and finally six outcome measures were accepted. The final core set was accepted with a median of 7.
Conclusion(s): This study present an outcome set that is accepted by stakeholders as having added value in daily practice primary care in patients with NSLBP in primary care physical therapy. In a next project this outcome set will be tested on his reliability and feasibility in a large pilot.
Implications: This consensus based core outcome set is the first step in the development of accepted quality indicators based on treatment outcomes.
Keywords: Nonspecific low back pain, outcome measures, PROMs
Funding acknowledgements: Dutch Health Insurance company CZ
Purpose: To develop a clinical core set of outcome measures that is accepted for relevance, feasibility and validity by stakeholders and useful for a) interaction between patient and professional, b) internal quality improvement, and c) external transparency in patients with NSLBP in primary care physical therapy.
Methods: We used a consensus-driven modified RAND-UCLA Delphi technique. In total we conducted seven separate steps with panellists (physical therapists, patient representatives, health insurers) to select accepted outcomes. These seven steps consisted of a literature search, two online surveys, patient interviews, an experts meeting, a consensus meeting and final approval of an advisory board. Results of previous steps were discussed during the consensus meeting, and then panellists voted for inclusion per measure. In the last online survey the final core set were rated on relevance en feasibility on a 9 point Likert scale, when the median was ≥7 the core sets was accepted.
Results: 34 panellists in two online surveys, five panellists in an expert committee, ten patients for semi-structured interviews and 26 panellists in a consensus meeting participated in the study. In total 12 outcome measures were rated and discussed and finally six outcome measures were accepted. The final core set was accepted with a median of 7.
Conclusion(s): This study present an outcome set that is accepted by stakeholders as having added value in daily practice primary care in patients with NSLBP in primary care physical therapy. In a next project this outcome set will be tested on his reliability and feasibility in a large pilot.
Implications: This consensus based core outcome set is the first step in the development of accepted quality indicators based on treatment outcomes.
Keywords: Nonspecific low back pain, outcome measures, PROMs
Funding acknowledgements: Dutch Health Insurance company CZ
Topic: Musculoskeletal: spine; Primary health care
Ethics approval required: Yes
Institution: Radboud Institute for Health Sciences
Ethics committee: Commissie Mensgebonden Onderzoek regio Arnhem-Nijmegen
Ethics number: 2017-3154
All authors, affiliations and abstracts have been published as submitted.
