Occupational therapy services in primary care: a scoping review

Abstract

Aim: To examine and describe the current evidence about occupational therapy services in primary care. Background: Interprofessional primary care teams have been introduced to support the changing demographics and provide more comprehensive and coordinated care. Occupational therapists have the opportunity to play an important role in this expanding area of practice. To do so, occupational therapists must develop roles built on evidence and a clear understanding of the care delivery context. Methods: A scoping review was conducted based on the scientific and grey literature. Studies that described or examined the occupational therapy role with clients (individuals, groups, communities, populations) of all ages, conditions or occupational issues in a primary care context and that presented or referred to an occupational therapist working in a primary care setting were included. Studies were excluded if they were not in English or French. The Canadian Model of Occupational Performance and Engagement was used to chart the data. Findings: 129 articles were identified, with 62 non-research and 67 research-focussed articles. A total of 268 assessments and 868 interventions were identified. The top interventions offered by occupational therapists were referring to/advocating for/coordinating/linking to and navigating community services (n = 36 articles), chronic disease management (n = 34 articles)/self-management education (n = 28 articles), health promotion (n = 30 articles) and falls prevention (n = 27 articles). The predominant focus in the literature is on adult and older adult populations.

Profiling the Research Activities of Canadian Occupational Therapy and Occupational Science Faculty Members

“…Given the broad scope of OT practice (American Occupational Therapy Association, 2021), it was not surprising respondents identified a wide range of research topics. Many established and emerging areas of practice require growth of the evidence base to support practice and advance the profession, such as primary care (Donnelly et al, in press), health promotion (Janssen et al, 2021), and telerehabilitation (Hung & Fong, 2019), to name a few. However, the limited funding and number of OT and OS faculty members conducting research suggest that faculty members, practitioners, and individuals with lived experience need to work together to identify research priorities that are flexible and translatable into more focused research questions within areas of OT practice (Pighills et al, 2013; Watson et al, 2021).…”

Management of Chronic Pain by Occupational Therapist: A Description of Practice Profile

“…The Quebec (Canada) health care service system is based on a principle of service hierarchy, which facilitates the complementarity of services and the flow of person between first-, second-, and third-line services. Sharing a common philosophical basis with the profession of occupational therapy, primary health care aims to offer a variety of services for the treatment and prevention of disability, support a healthy lifestyle, promote health and increase social participation according to person's needs and preferences (as individuals, families, and communities) (Donnelly et al, 2023; World Health Organization, 2018).…”

“…Primary care is a relatively new practice setting for occupational therapists and offers a unique opportunity for the profession to draw on a health promotion perspective, as it has recently been demonstrated in a scoping review (Donnelly et al, 2023). Our results reported slightly less than half (42.2%) of occupational therapists working in primary care, mostly in private practice.…”

“…None of the surveyed occupational therapists were involved in Family Medicine Groups, although this has been identified as a strategic clinical setting for optimal CP management pain (Campbell et al, 2019). Moreover, the review by Donnelly et al demonstrated a breadth of contributions that occupational therapists are making in primary care, while focussing on understanding how individuals are engaging in everyday activities and supporting them to participate in their daily activities by building or adapting individual capacity, engaging in occupations, and ensuring safe and accessible environments (Donnelly et al, 2023). Even though physicians recognize several benefits of integrating occupational therapists into Family Medicine Groups (e.g., facilitate return to work, carry out group interventions on activation, healthy lifestyles, and pain management) (Locas et al, 2020), occupational therapists are still under-integrated into primary care teams (Dahl-Popolizio & Rogers, 2017); Donnelly et al, 2023; Locas et al, 2020).…”

“…b Multidisciplinary team consists of a grouping of several stakeholders where each professional performs his or her task independently. et al, 2023;Locas et al, 2020). In Quebec, this might be explained by a lack of visibility and knowledge about the role of occupational therapists can play in CP management teams (Locas et al, 2020).…”