THE USE OF OUTCOME MEASURES BY HEALTHCARE PROFESSIONALS FOR YOUNG PEOPLE WITH ADOLESCENT IDIOPATHIC SCOLIOSIS: A QUALITATIVE EXPLORATION

S. Alamrani^1,2, A. Gardner³, D. Falla¹, E. Russell⁴, A.B. Rushton⁵, N.R. Heneghan¹

¹School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), Birmingham, United Kingdom, ²University of Tabuk, Physical Therapy Department, College of Applied Medical Science, Tabuk, Saudi Arabia, ³The Royal Orthopaedic Hospital, Spine Unit, Birmingham, United Kingdom, ⁴Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom, ⁵Western University, School of Physical Therapy, London, Ontario, Canada

Background: Young people with adolescent idiopathic scoliosis (AIS) is the most common spinal deformity in paediatric population. Limited knowledge is available about the current use of outcome measure for those with AIS as well as perceived barriers and facilitators of health care professionals (HCP).

Purpose: 1) To explore current practice of using patient reported outcome measure (PROM) for those with AIS.
2) To understand perceived barriers and facilitators to use performance-measure.

Methods: A qualitative study design reported according to the COnsildated criteria for REporting Qualitative study guidelines. A convenience sample from HCP were recruited from tertiary hospital in United Kingdom. Mean years of experience in management of individuals with AIS was 11.8 years, and included surgeons, physiotherapists, and nurses, educated at Bachelor, Masters, and Doctoral level. Consent to participate and demographic information were collected in advance of the interview. In-depth,virtual semi-structured interviews lasted approximately 45 minutes, informed by an evidence informed topic guide. Interviews were audio and video recorded and transcribed verbatim along with field notes. Data coded and analysed using inductive thematic analysis, involving topic and methodological expertise as well as the input of a PPI representative.

Results: Three themes emerged regarding current practice of using PROM 1) routine practice 2) personal evaluations and 3) monitoring outcomes. The themes that emerged as barriers to use PROM for those with AIS included 1) priority and support (e.g., HCP focus on providing care) 2) practical challenges (e.g., PROM not informing practice) 3) patients’ challenges (e.g., who do not want to participate) 4) knowledge, education, and perceived value. Themes emerged as facilitators included 1) quality of existing measure (e.g., sufficient psychometric properties) 2) priority and support (e.g., research department/culture) 3) fit into practice. Barriers to use of performance measure were 1) practicality (e.g., need physical space) 2) perceived value (PROM are more important) 3) knowledge and experience, while facilitator was practical consideration (e.g., acceptability)

Conclusions: Findings confirmed a perceived importance by HCPs of using outcome measure for individuals with AIS. Potential barriers and facilitators recognized in this study could be utilized to enhance use of outcome measures in routine clinical practice. Considerably more work will need to be done to determine the usefulness of performance measures to individuals with AIS.

Implications: Greater efforts are still needed to enhance use of OM for individuals with AIS, by applying different strategies at both at individual and organisational level.

Funding acknowledgements: No funding received to support this work. Samia is a PhD student supported by a scholarship from university of Tabuk

Keywords:
Adolescent with idiopathic scoliosis
Outcome measure
Qualitative study

Topics:
Professional practice: other
Musculoskeletal: spine
Paediatrics

Did this work require ethics approval? Yes

Institution: NHS

Committee: Health Research Authority and Health and Care Research Wales approval

Ethics number: 21/WM/0076