Access and perceived need for physical and occupational therapy in chronic arthritis

Feldman, Debbie Ehrmann; Bernatsky, Sasha; Lévesque, Jean Frédéric; Van, My Tram; Houde, Michelle; April, Karine Toupin

doi:10.3109/09638281003734417

Cited by 22 publications

(30 citation statements)

References 17 publications

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“…Treatments for chronic noncancer pain are numerous, often costly, and often associated with a variety of health risks [6-20]. Chronic pain treatments include, but are not limited to, the use of opioid and other analgesic medications [9-11,16,21,22], surgical procedures [19,23], injections [24-26], nerve ablations [15], spinal cord stimulators [20,27], physical and occupational therapies [28], biofeedback [29,30], transcutaneous electrical nerve stimulation (TENS) units [31], psychological interventions [32-41], and comprehensive multidisciplinary pain programs [42-45]. Chronic pain is a complex family of disorders with a wide range of causes and courses (eg, disease, injury), and is frequently maintained or exacerbated by additional psychological, behavioral, social, and environmental factors (eg, stress, depression, sleep dysfunction, physical inactivity, financial stress, legal disability) [14,46-48].…”

Section: Introductionmentioning

confidence: 99%

Effects of an Individually Tailored Web-Based Chronic Pain Management Program on Pain Severity, Psychological Health, and Functioning

Nevedal

Wang²,

Oberleitner³

et al. 2013

J Med Internet Res

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BackgroundIt is estimated that 30% of adults in the United States experience daily chronic pain. This results in a significant burden on the health care system, in particular primary care, and on the workplace. Chronic pain management with cognitive-behavioral psychological treatment is effective in reducing pain intensity and interference, health-related quality of life, mood, and return to work. However, the population of individuals with chronic pain far exceeds the population of therapists that can provide this care face-to-face. The use of tailored, Web-based interventions for the management of chronic pain could address limitations to access by virtue of its unlimited scalability.ObjectiveTo examine the effects of a tailored Web-based chronic pain management program on subjective pain, activity and work interference, quality of life and health, and stress.MethodsEligible participants accessed the online pain management program and informed consent via participating employer or health care benefit systems; program participants who completed baseline, 1-, and 6-month assessments were included in the study. Of the 645 participants, the mean age was 56.16 years (SD 12.83), most were female (447/645, 69.3%), and white (505/641, 78.8%). Frequent pain complaints were joint (249/645, 38.6%), back (218/645, 33.8%), and osteoarthritis (174/654, 27.0%). The online pain management program used evidence-based theories of cognitive behavioral intervention, motivational enhancement, and health behavior change to address self-management, coping, medical adherence, social support, comorbidities, and productivity. The program content was individually tailored on several relevant participant variables.ResultsBoth pain intensity (mean 5.30, SD 2.46), and unpleasantness (mean 5.43, SD 2.52) decreased significantly from baseline to 1-month (mean 4.16, SD 2.69 and mean 4.24, 2.81, respectively) and 6-month (mean 3.78, SD 2.79 and mean 3.78, SD 2.79, respectively) assessments (P<.001). The magnitude of the 6-month effects were large. Trends for decreases in pain interference (36.8% reported moderate or enormous interference) reached significance at 6 months (28.9%, P<.001). The percentage of the sample reporting fair or poor quality of life decreased significantly from 20.6% at baseline to 16.5% at 6 months (P=.006).ConclusionsResults suggest that the tailored online chronic pain management program showed promising effects on pain at 1 and 6 months posttreatment and quality of life at 6 months posttreatment in this naturalistic study. Further research is warranted to determine the significance and magnitude of the intervention’s effects in a randomized controlled trial.

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Section: Introductionmentioning

confidence: 99%

Effects of an Individually Tailored Web-Based Chronic Pain Management Program on Pain Severity, Psychological Health, and Functioning

Nevedal

Wang²,

Oberleitner³

et al. 2013

J Med Internet Res

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“…Feldman and colleagues, who conducted interviews directly with patients, found that 96% of patients who felt they needed rehabilitation services received these services; however, only 26.1% of their sample perceived a need for rehabilitation services. 20 Our study was based on hypothetical scenarios of patients who were presumably referred to PT and OT because of their physician's assessment of need, yet only 26% were given an appointment within 12 months of referral.…”

Section: Discussionmentioning

confidence: 99%

“…In fact, the therapists believed that in many cases physicians do not even initiate a referral because they are well aware that the patient will be unable to access a therapist. 19 People with higher levels of education are also more likely to perceive the need for therapy services, [20][21][22][23][24] which may indicate increased knowledge about potential benefits.…”

Section: Discussionmentioning

confidence: 99%

Wait Times for Physical and Occupational Therapy in the Public System for People with Arthritis in Quebec

Delaurier

Bernatsky

Raymond

et al. 2013

Physiotherapy Canada

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Purpose: Although arthritis is the leading cause of pain and disability in Canada, and physical therapy (PT) and occupational therapy (OT) are beneficial both for chronic osteoarthritis (OA) and for inflammatory arthritis such as rheumatoid arthritis (RA), there appear to be problems with access to such services. The aim of this study was to document wait times from referral by physician to consultation with PT or OT in the public health care system for people with arthritis in Quebec, Canada. Method: Appointments were requested by telephone, using hypothetical case scenarios; wait times were defined as the time between initial request and appointment date. Descriptive statistics were used to examine the wait times in relation to diagnosis, service provider and geographic area. Results: For both scenarios (OA and RA) combined, 13% were offered an appointment within 6 months, 13% offered given an appointment within 6-12 months, 24% were told they would need to wait longer than 12 months, and 22% were refused services. The remaining 28% were told they would require an evaluation appointment for functional assessment before being given an appointment for therapy. No difference was found between RA and OA diagnoses. Conclusions: Our study suggests that most people with arthritis living in the province of Quebec are not receiving publicly accessible PT or OT intervention in a timely manner.Key Words: arthritis; health services accessibility; rehabilitation. RÉ SUMÉObjet : Mê me si l'arthrite constitue la principale cause de douleur et d'incapacité au Canada et si la physiothé rapie (PT) et l'ergothé rapie (ET) sont bé né -fiques à la fois contre l'arthrose chronique (AC) et l'arthrite inflammatoire comme la polyarthrite rhumatoïde (PR), il semble y avoir des problè mes d'accè s à ces services. Cette é tude visait à documenter les temps d'attente entre la ré fé rence par le mé decin et la consultation en PT ou ET dans le systè me public de soins de santé pour les personnes atteintes d'arthrite au Qué bec, Canada. Mé thode : On a demandé des rendez-vous par té lé phone en utilisant des scé narios de cas hypothé tiques. Les temps d'attente ont é té dé finis comme le temps é coulé entre la demande initiale et la date du rendez-vous. Nous avons utilisé des statistiques descriptives pour analyser les temps d'attente par rapport au diagnostic, au fournisseur de service et à la ré gion gé ographique. Ré sultats : Pour les deux scé narios (AC et PR) combiné s, 13 % ont reçu un rendez-vous dans les six mois, 13 %, en six à 12 mois, on a dit à 24 % qu'ils devraient attendre plus de 12 mois et l'on a refusé des services dans 22 % des cas. Dans les 28 % de cas restants, on a dit que la personne en cause aurait besoin d'un rendez-vous d'é valuation fonctionnelle avant d'obtenir un rendez-vous de traitement. On n'a constaté aucune diffé rence entre les diagnostics de PR et d'AC. Conclusions : Notre é tude indique que la plupart des personnes qui vivent avec l'arthrite dans la province de Qué bec ne reçoivent pas en temps op...

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“…21 A seleção dos métodos de avaliação deve levar em consideração as queixas principais do paciente e sua relevância para o quadro clínico apresentado. 23 A tabela 1 ilustra alguns dos instrumentos de avaliação padronizados que compõem a avaliação terapêutica ocupacional do paciente com AR.…”

Section: Avaliação Em Terapia Ocupacionalunclassified

Terapia ocupacional na artrite reumatoide: o que o reumatologista precisa saber?

Almeida

Pontes

Matheus

et al. 2015

Revista Brasileira de Reumatologia

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Interventions focusing on education and self-management of rheumatoid arthritis (RA) by the patient improves adherence and effectiveness of early treatment. The combination of pharmacologic and rehabilitation treatment aims to maximize the possibilities of intervention, delaying the appearance of new symptoms, reducing disability and minimizing sequelae, decreasing the impact of symptoms on patient's functionality. Occupational therapy is a health profession that aims to improve the performance of daily activities by the patient, providing means for the prevention of functional limitations, adaptation to lifestyle changes and maintenance or improvement of psychosocial health. Due to the systemic nature of RA, multidisciplinary follow-up is necessary for the proper management of the impact of the disease on various aspects of life. As a member of the health team, occupational therapists objective to improve and maintaining functional capacity of the patient, preventing the progression of deformities, assisting the process of understanding and coping with the disease and providing means for carrying out the activities required for the engagement of the individual in meaningful occupations, favoring autonomy and independence in self-care activities, employment, educational, social and leisure. The objective of this review is to familiarize the rheumatologist with the tools used for assessment and intervention in occupational therapy, focusing on the application of these principles to the treatment of patients with RA.

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Access and perceived need for physical and occupational therapy in chronic arthritis

Cited by 22 publications

References 17 publications

Effects of an Individually Tailored Web-Based Chronic Pain Management Program on Pain Severity, Psychological Health, and Functioning

Effects of an Individually Tailored Web-Based Chronic Pain Management Program on Pain Severity, Psychological Health, and Functioning

Wait Times for Physical and Occupational Therapy in the Public System for People with Arthritis in Quebec

Terapia ocupacional na artrite reumatoide: o que o reumatologista precisa saber?

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