Physical Therapy Utilization in Hospice and Palliative Care Settings in Michigan: A Descriptive Study*

Drouin, Jacqueline S.; Martin, Krystal; Onowu, Nneka; Berg, Arika; Zuellig, Lynn

doi:10.1097/01893697-200927020-00001

Cited by 11 publications

(17 citation statements)

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“…This is in stark contrast to Drouin et al, 36 who found that family education was the most common treatment used. In American settings, medical insurance criteria can restrict the number of physiotherapy visits; therefore, family education possibly becomes a more appropriate therapy goal.…”

Section: Treatments Utilizedcontrasting

confidence: 54%

“…34 They were also widely used by physiotherapists in Michigan. 36 Mobility training, therefore, appears to be the prime role of the physiotherapists in palliative care units. Pain-relieving treatments including heat, ice, manual therapy and transcutaneous electrical neuromuscular stimulation (TENS) were used on 17% of patients.…”

Section: Treatments Utilizedmentioning

confidence: 99%

“…It is sharply at odds with the rate of 3% in palliative facilities in Michigan. 36 In the United States, it is usually necessary for treatments to conform to insurance company criteria, 41 which may impact negatively on utilization rates. The latter study population had only 53% cancer patients, compared with 88% in this study, which might also explain the variation.…”

Section: General Information and Referral Ratementioning

confidence: 99%

“…Interferential current and ultrasound were available but not used. In the Michigan study, 36 therapists used heat, ice, massage, traction, and ultrasound. Despite primary medical control of pain, physiotherapists, therefore, continue to have a role in pain relief for hospice patients.…”

Section: Treatments Utilizedmentioning

confidence: 99%

“…In contrast, in Michigan, utilization rate was 3% in palliative facilities in 2009. 36 Physiotherapy also benefits community-based hospice patients. 37 Very little else informs practice in this field.…”

mentioning

confidence: 99%

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Physical Function in Hospice Patients and Physiotherapy Interventions: A Profile of Hospice Physiotherapy

Cobbe¹,

Kennedy

2012

Journal of Palliative Medicine

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Objective: There is a dearth of international research on hospice physiotherapy. This study aims to profile hospice physiotherapy in an Irish setting in order to inform practice internationally. Design: The study design consisted of a retrospective chart audit over 6 months. Setting: The study took place at a specialist palliative care inpatient unit (hospice) in Limerick, Ireland. Participants: All patients were discharged (through death or discharge onwards) from January to June 2010. Outcome measure: The Edmonton Functional Assessment Tool (EFAT-2) was used as an outcome measure. Results: Sixty-five percent were referred for physiotherapy; 58% (n = 144) were assessed and treated. A wide range of patients was referred (mean functional score 11, range 1-23, SD 5). Rehabilitation activities were widespread: 48% with more than one functional score recorded made improvements; 53% of physiotherapy patients were eventually discharged home; 47% of physiotherapy patients died, of whom 52% received physiotherapy in the last week of life. The median physiotherapy program lasted 11 days (range 1-186, SD 22) whereas the median number of treatments was four (range 1-99, SD 10). The most common interventions were gait re-education (67%), transfer training (58%), and exercises (53%). One third of treatment attempts were unsuccessful because of the unavailability/unsuitability of patients. Challenges for physiotherapists included frequent suspension of treatment and large functional fluctuations in patients. Conclusion: There was a high referral rate to physiotherapy in this hospice. Functional changes in hospice patients were mapped, showing that physiotherapy involved both rehabilitative and quality of life/supportive measures. The most common treatments were physical activity interventions.

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Section: Treatments Utilizedcontrasting

confidence: 54%

Section: Treatments Utilizedmentioning

confidence: 99%