Occupational therapists, like other health care professionals, are constantly being asked to confront major changes in the way health and social care services are structured and, in turn, how their working practices are organised. In order for the market-driven National Health Service to function, it requires detailed information on whether services are clinically effective. The use of evidence-based practice has been widely advocated as one way to meet these demands. This article focuses on evidence-based practice as an approach, and considers its implications and relevance for occupational therapists. First, a short history of the background of evidence-based practice is given, followed by a discussion of recent social and political developments which have increased demands for its wider use. A number of key issues associated with evidence-based practice are then considered, including implementing research findings into practice; the nature of evidence itself; time; the accessibility of research findings; and skills required for evidence-based practice. Practical suggestions are also offered to enable therapists to make the most appropriate use of evidence-based practice. The aim of this article is to stimulate debate about evidence-based decision making for practitioners.
From a policy perspective, the lack of difference in clinical and cost-effectiveness means that either a social work or an occupational therapy service is successful in making care assessments that enable an older person to remain in their own home.
There was no clear difference in patient-centred effectiveness measures between occupational therapists and social workers in assessing frail older people and their carers in the community. More extensive use of primary care health services by occupational therapists may have contributed to the differences in EQ-5D scores for carers. Delays in making occupational therapy assessments and in completing recommended housing adaptations may have contributed to these negative findings.
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