Patient‐reported outcome measures in advanced musculoskeletal physiotherapy practice: a systematic review

Fennelly, Orna; Blake, Catherine; Desmeules, François; Stokes, Diarmuid; Cunningham, Caitríona

doi:10.1002/msc.1200

Cited by 37 publications

(35 citation statements)

References 113 publications

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“…We only tested GPE as outcome and do not know if visual patterns predict other utilized core patient-reported outcomes such as pain, impairment and disability (Fennelly, Blake, Desmeules, Stokes, & Cunningham, 2018). Different defined outcomes like symptoms, functions or health-related quality of life should be tested for visual patterns.…”

Section: Future Implicationsmentioning

confidence: 99%

Visual trajectory pattern as prognostic factors for neck pain

Myhrvold

Irgens

Robinson

et al. 2020

European Journal of Pain

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Background A novel approach capturing both temporal variation and pain intensity of neck pain is by visual trajectory patterns. Recently, both previous and expected visual trajectory patterns were identified as stronger predictors of outcome than traditional measures of pain history and psychological distress. Our aim was to examine patient characteristics within the various previous and expected patterns, relationship between the two patterns and predictive value of a variable combining the previous and expected patterns. Methods Patients with neck pain (n = 932) consulting chiropractors were included. Baseline measures included pain intensity, disability, psychological variables and symptom history and expectations. Participants reported global perceived effect after 12 weeks. Analyses included descriptive statistics and logistic regression. Results Pain intensity, disability, psychological and worse outcome expectations increased from a single pain episode to severe ongoing pain of previous and expected patterns. Having a severe pain history was associated with poor prognosis, particularly if combined with negative expectations. The variable combining previous and expected patterns had a discriminative ability similar to that of other predictors AUC = 0.64 (95% CI = 0.60–0–67) versus AUC = 0.66 (95% CI = 0.62–0.70). The model with highest discriminative ability was achieved when adding the combined patterns to other predictors AUC = 0.70 (95% CI = 0.66–0.73). Conclusion The study indicates that pain expectations are formed by pain history. The patients’ expectations were similar to or more optimistic compared with their pain history. The prognostic ability of the model including a simplified combination of previous and expected patterns, together with a few other predictors, suggests that the trajectory patterns might have potential for clinical use. Significance The dynamic nature of neck pain can be captured by visual illustrations of trajectory patterns. We report, that trajectory patterns of pain history and future expectations to some extent are related. The patterns also reflect a difference in severity assessed by higher degree of symptoms and distress. Moreover, the visual trajectory patterns predict outcome at 12‐weeks. Since the patterns are easily applicable, they might have potential as a clinical tool.

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Section: Future Implicationsmentioning

confidence: 99%

Visual trajectory pattern as prognostic factors for neck pain

Myhrvold

Irgens

Robinson

et al. 2020

European Journal of Pain

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“…APPs were also frustrated that the service remained focused on wait times and patient throughput, rather than on patient‐focused outcomes. This lack of emphasis on patient outcomes is also reflected in the international literature (Comans, Clark, Cartmill, Ash, & Sheppard, ; Fennelly, Blake, Desmeules, et al, ). Further research, comparing the effects of different service designs and operating procedures on patient outcomes, such as APPs providing follow‐up physiotherapy treatment, would identify the most efficacious model of care.…”

Section: Discussionmentioning

confidence: 99%

“…Increased demands on health services, with growing waiting lists, staff and skill shortages, and need for cost containment (Jones, Powell, Watkins, & Kelly, ; McPherson et al, ), together with recognition of the wider clinical expertise and competence of various health disciplines, have driven the transformation of healthcare models with the development of advanced practice health professional roles. Physiotherapy is one such discipline which has broadened its practice remit in the UK, Canada, New Zealand, Australia, Sweden and, more recently, in Ireland (Fennelly, Blake, Desmeules, Stokes, & Cunningham, ). Enhancement in scope of practice sees physiotherapists conducting tasks that are traditionally more aligned with a medical scope of practice, with increased autonomy (Desmeules et al, ).…”

Section: Introductionmentioning

confidence: 99%

“…Given that advanced practice represents a ‘level of practice’ as opposed to a specific role (Chartered Society of Physiotherapy, ), resultant APP service operating procedures are often dependent on individual hospital system policies, hospital regulatory mechanisms and individual consultant doctor (i.e., senior specialist doctor) preferences. Variances therefore exist in APP roles, even within the same country (Fennelly, Blake, Desmeules, et al, ), making it difficult to ensure widespread professional recognition and, thus, doctors' confidence in APP triage (King, Tod, & Sanders, ), and generalize research findings to other settings. Owing to this diversity, comprehensive evaluation of newly established APP services requires inclusion of all APP sites, as well as documentation of tasks performed, autonomy, training and qualifications (Stanhope, Grimmer‐Somers, Milanese, Kumar, & Morris, ).…”

Section: Introductionmentioning

confidence: 99%

“…As well as reducing wait times by increasing workforce capacity, implementation of this new interprofessional model of care has the potential to improve patient outcomes. Further research on patient‐reported outcome measures (PROMs) is necessary and requires investigation of what is currently captured and deemed important to capture, by APPs (Fennelly, Blake, Desmeules, et al, ).…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Advanced musculoskeletal physiotherapy practice in Ireland: A National Survey

Fennelly

Blake

FitzGerald

et al. 2018

Musculoskeletal Care

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Benchmarking community/primary care musculoskeletal services: A narrative review and recommendation

Burgess

Lewis

Hill

2022

Musculoskeletal Care

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Introduction: High quality data on service performance is essential in healthcare to evidence efficacy, efficiency, and value. There remains a paucity of publicly reported data in community and primary care musculoskeletal (MSK) services. There is also a lack of guidance on which metrics MSK services should be collecting and reporting, and how this data could be used to directly improve patient outcomes, experiences, and value.Method: A narrative review of the evidence around benchmarking MSK services was undertaken with a focus on how to develop routine data collection within community/primary care settings, and how to develop benchmarking capabilities for the future, looking towards a national MSK audit. This evidence was triangulated with the findings from recent MSK data studies undertaken by the authors and emerging UK policy and guidance in this area. Recommendations:To enable MSK benchmarking services need to collect consistent, standardised outcomes and, therefore, we have developed a recommendation on a minimum MSK 'core outcome set' of Patient Reported Outcome Measures (PROMs) and Patient Reported Experience Measures (PREMs) (PROMs: MSK-HQ, NPRS, WPAI; PREMs: National MSK PREM). In addition, we make recommendations on the use of a standardised evidence-based method for case-mix adjustment and outlier identification (using the following baseline demographics and clinical factors; age, sex, ethnicity, pain site, comorbidities, duration of symptoms, previous surgery, previous pain episodes), alongside considerations on how this data should be integrated and reported within NHS systems. Conclusions:Capturing high quality MSK data in a standardised, consistent, and sustainable way is a significant challenge. Policy holders, commissioners, managers, and clinicians need to be realistic with expectations, and take time to explore barriers to implementation including, funding, digital infrastructure/intra-operability, data sharing/governance, digital literacy, and local/national leadership. Next steps include developing a national MSK audit programme to provide a benchmarking model to support continuous improvements in care quality for patients living with MSK conditions.

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Patient‐reported outcome measures in advanced musculoskeletal physiotherapy practice: a systematic review

Cited by 37 publications

References 113 publications

Visual trajectory pattern as prognostic factors for neck pain

Visual trajectory pattern as prognostic factors for neck pain

Advanced musculoskeletal physiotherapy practice in Ireland: A National Survey

Benchmarking community/primary care musculoskeletal services: A narrative review and recommendation

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