Adult Measures of General Health and Health‐Related Quality of Life

Busija, Ljoudmila; Ackerman, Ilana N.; Haas, Romi; Wallis, Jason; Nolte, Sandra; Bentley, Sharon A; Miura, Daisuke; Hawkins, Melanie; Buchbinder, Rachelle

doi:10.1002/acr.24216

Cited by 29 publications

(16 citation statements)

References 270 publications

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“…For context, the minimal clinically important difference for pain following interventions for people with OA is an absolute change of 2.0 units on a numeric rating scale [44], which suggests that therapeutic alliance may not have a clinically significant impact on pain. In quality of life, a 1-SD increase in physical therapist-rated therapeutic alliance score in our study corresponds to a 0.055-unit improvement in quality of life, approximating the estimated minimal clinically important difference of 0.06 on the AQoL [45]. Minimal clinically important differences for other outcome measures that we found were associated with therapeutic alliance (including self-efficacy and fear of movement) are unknown [46], and as such, the clinical significance of associations with these outcomes is unclear.…”

Section: Comparison With Earlier Worksupporting

confidence: 57%

Association Between Therapeutic Alliance and Outcomes Following Telephone-Delivered Exercise by a Physical Therapist for People With Knee Osteoarthritis: Secondary Analyses From a Randomized Controlled Trial (Preprint)

Lawford¹,

Bennell²,

Campbell³

et al. 2020

Preprint

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BACKGROUND The therapeutic alliance between patients and physiotherapists has been shown to influence clinical outcomes in patients with chronic low back pain when consulting in-person. However, no studies have examined whether the therapeutic alliance developed between patients with knee osteoarthritis and physiotherapists during telephone consultations influences clinical outcomes. OBJECTIVE Investigate whether the therapeutic alliance between patients with knee osteoarthritis and physical therapists, measured after the second consultation, is associated with outcomes following telephone-delivered exercise and advice. METHODS Secondary analysis of 87 patients in the intervention arm of a randomised controlled trial allocated to receive 5-10 telephone consultations with one of 8 physical therapists over 6-months, involving education and prescription of a strengthening and physical activity program. Separate regression models investigated the association between patient and therapist ratings of therapeutic alliance (measured after the second consultation using the Working Alliance Inventory Short Form) and outcomes (pain, function, self-efficacy, quality of life, global change, adherence to prescribed exercise and physical activity) at 6- and 12-months, with relevant covariates included. RESULTS There was some evidence of weak association between patient ratings of the alliance and some outcomes at 6-months (improvements in average knee pain [regression coefficient (95% confidence interval): 0.10 (0.03 to 0.16)], self-efficacy [-0.16 (-0.28 to -0.04)], global improvement in function [odds ratio: 1.26 (1.04 to 1.39)], and overall improvement [odds ratio: 1.26 (1.06 to 1.51)], but also with worsening in fear of movement [regression coefficient: 0.13 (0.04 to 0.23)]). There was also some evidence of weak association between patient ratings of the alliance and some outcomes at 12 months (improvements in self-efficacy [regression coefficient: -0.15 (-0.27 to -0.03)], global improvement in both function [odds ratio: 1.19 (0.03 to 1.37)] and pain [odds ratio: 1.14 (1.01 to 1.30)], and overall improvement [odds ratio: 1.21 (1.02 to 1.42)]). Data suggest associations between therapist ratings of therapeutic alliance and outcomes were not strong, except for improved quality of life at 12-months (regression coefficient: -0.01 (-0.01 to -0.0003)). CONCLUSIONS Higher patient, but not therapist, ratings of therapeutic alliance were weakly associated with improvements in some clinical outcomes, but worsening in one. Although findings suggest that patients who perceive a stronger alliance with their therapist may achieve better clinical outcomes, observed relationships were generally weak and of uncertain clinical significance. CLINICALTRIAL n/a

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Section: Comparison With Earlier Worksupporting

confidence: 57%

Association Between Therapeutic Alliance and Outcomes Following Telephone-Delivered Exercise by a Physical Therapist for People With Knee Osteoarthritis: Secondary Analyses From a Randomized Controlled Trial (Preprint)

Lawford¹,

Bennell²,

Campbell³

et al. 2020

Preprint

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“…Most widely used generic patient reported outcome, and is valid and reliable. (43) The EQ-5D-5L index was calculated using an an England-based value set (43) as it closely resembled the Australian population (44).…”

Section: Participant Recruitment and Data Collectionmentioning

confidence: 99%

Program Evaluation of GLA:D® Australia: Physiotherapist Training Outcomes and Effectiveness of Implementation for People With Knee Osteoarthritis

Barton

Kemp

Roos

et al. 2021

Preprint

Self Cite

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BackgroundThe Good Life with osteoArthritis from Denmark (GLA:D®) program incorporates guideline-based patient education and exercise-therapy for osteoarthritis to implement guidelines into practice. We evaluated the implementation of GLA:D® for knee osteoarthritis within Australian physiotherapy practice using the RE-AIM QuEST (Reach, Effectiveness, Adoption, Implementation, Maintenance Qualitative Evaluation for Systematic Translation) framework.MethodsAustralian physiotherapists were trained and supported to deliver GLA:D® (2017-2019) and completed surveys before and after training to assess practices, beliefs about capabilities and confidence, and barriers and enablers to implementation. Patients participating in GLA:D® completed online baseline, 3-month (immediately post-treatment) and 12-month patient reported outcomes. Effective implementation was defined as within-subject moderate effect size (ES, ≥0.50) for average pain (100mm visual analogue scale) and knee osteoarthritis outcome score quality of life scores (KOOS-QoL), and small effect size (≥0.20) for health-related quality of life (EQ-5D-5L).ResultsReach: 1,064 physiotherapists (73% private) and 1,945 (79% private) from all states and territories consented to participation. Key barriers included out-of-pocket cost to patients, and program suitability for culturally and linguistically diverse communities. Effectiveness: Following training, more physiotherapists discussed treatment goals and the importance of weight management, and prescribed supervised, neuromuscular exercise. Patient outcomes at 3- and 12 months (n = 1,044 [54%] and 927 [48%]) reflected effective implementation, including reduced pain intensity (ES, 95%CI = 0.72, 0.62-0.84; and 0.65, 0.54-0.77), improved KOOS-QoL scores (0.79, 0.69-0.90; and 0.93, 0.81-1.04), and improved EQ-5D-5L scores (0.43, 0.31-0.54; and 0.46, 0.35-0.58). Seventy-three percent of participants reported minimal important changes for at least one of pain severity (≥ 15 mm), KOOS-QoL (≥ 15 points) or EQ-5D-5L (≥ 0.07 points). Adoption: GLA:D® was implemented at 297 sites (264 private, 33 public). Implementation: Most patients completed at least one education (90%), and 10 exercise-therapy (78%) sessions. Adequate staffing to support program delivery was a key enabler. Maintenance: Ninety-nine percent of sites (293/297) continued to offer the program in July 2020.ConclusionsTraining was associated with practice changes and widespread implementation of GLA:D® in Australia. Effective implementation, and clinically meaningful improvements in pain and quality of life for most participant, supports further work to scale up GLA:D® in Australia.

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“…Para a população cardiopata, a QV foi avaliada através dos instrumentos MLHFQ, composto de 27 itens e com um escore de 0 a 105 pontos, e MacNew, constituído de 21 itens e com um escore máximo de 7 para todos os domínios 18 . Para os sujeitos sem evento cardíaco prévio, foram utilizados os questionários SF-36, composto de 36 itens e com um escore de 0 a 100 pontos para todos os domínios e o PSN, formado por 38 itens e com um escore de 0 a 38 pontos 19 . Todos os instrumentos foram aplicados pela mesma entrevistadora, a fim de atenuar possíveis diferenças de compreensão devido a níveis educacionais distintos entre os participantes.…”

Section: Avaliação Da Qualidade De Vidaunclassified

Prevalência de disfunção sexual e incontinência urinária em indivíduos cardiopatas candidatos à reabilitação cardíaca e indivíduos sem evento cardíaco prévio

Albuquerque

Bittencourt²,

Santos³

et al. 2021

Saúde (Sta. Maria)

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Objetivo: Analisar a prevalência de disfunção sexual e incontinência urinária em sujeitos cardiopatas candidatos a um programa de reabilitação cardíaca (PRC), assim como comparar os achados a sujeitos sem evento cardíaco prévio (n=25) e correlacionar com as variáveis capacidade funcional (CF) e qualidade de vida (QV). Métodos: Trata-se de um estudo transversal com avaliação dos seguintes desfechos: disfunção sexual (Female Sexual Function Index e Índice Internacional de Função Erétil Simplificado), incontinência urinária (International Consultation Incontinence Questionnaire – Short Form, Incontinence Severity Index), qualidade de vida (Minnesota Living with Heart Failure Questionnaire e MacNew Heart Disease Health-Related Quality of Life Questionnaire para sujeitos cardiopatas e Medical Outcomes Study 36-Item Short-Form Health Survey e Notthingam Health Profile para sujeitos sem evento cardíaco prévio) e CF (teste de caminhada de 6 minutos). Resultados: A amostra foi composta por 25 indivíduos cardiopatas candidatos a um PRC (59,88 ± 8,53 anos, 19 homens) e 25 indivíduos sem evento cardíaco prévio (57,88 ± 9,54 anos, 19 homens). Não houve diferença significativa na prevalência de disfunção sexual e incontinência urinária entre os grupos. Houve correlação inversa e forte (r=-0,803; p=0,005) entre disfunção sexual e CF nos homens cardiopatas. Os pacientes cardiopatas demonstraram uma menor capacidade funcional quando comparados aos sujeitos sem evento cardíaco prévio. Considerações Finais: Ressalta-se a importância da abordagem de temas como disfunção sexual e incontinência urinária dentro de um PRC, sobretudo em função do manejo precoce dos seus fatores de risco.

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Adult Measures of General Health and Health‐Related Quality of Life

Cited by 29 publications

References 270 publications

Association Between Therapeutic Alliance and Outcomes Following Telephone-Delivered Exercise by a Physical Therapist for People With Knee Osteoarthritis: Secondary Analyses From a Randomized Controlled Trial (Preprint)

Association Between Therapeutic Alliance and Outcomes Following Telephone-Delivered Exercise by a Physical Therapist for People With Knee Osteoarthritis: Secondary Analyses From a Randomized Controlled Trial (Preprint)

Program Evaluation of GLA:D® Australia: Physiotherapist Training Outcomes and Effectiveness of Implementation for People With Knee Osteoarthritis

Prevalência de disfunção sexual e incontinência urinária em indivíduos cardiopatas candidatos à reabilitação cardíaca e indivíduos sem evento cardíaco prévio

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