Using Outcome Measures in Daily Practice: Development and Evaluation of an Implementation Strategy for Physiotherapists in the Netherlands

Abstract

Purpose: To describe the development of an educational programme for physiotherapists in the Netherlands, two toolkits of measurement instruments, and the evaluation of an implementation strategy. Method: The study used a controlled pre- and post-measurement design. A tailored educational programme for the use of outcome measures was developed that consisted of four training sessions and two toolkits of measurement instruments. Of 366 invited physiotherapists, 265 followed the educational programme (response rate 72.4%), and 235 randomly chosen control physiotherapists did not (28% response rate). The outcomes measured were participants' general attitude toward measurement instruments, their ability to choose measurement instruments, their use of measurement instruments, the applicability of the educational programme, and the changes in physiotherapy practice achieved as a result of the programme. Results: Consistent (not occasional) use of measurement instruments increased from 26% to 41% in the intervention group; in the control group, use remained almost the same (45% vs 48%). Difficulty in choosing an appropriate measurement instrument decreased from 3.5 to 2.7 on a 5-point Likert-type scale. Finally, 91% of respondents found the educational programme useful, and 82% reported that it changed their physiotherapy practice. Conclusions: The educational programme and toolkits were useful and had a positive effect on physiotherapists' ability to choose among many possible outcome measures.

A systematic review of interventions to increase the use of standardized outcome measures by rehabilitation professionals

“…Only one of the studies had strong ratings for any of the six components that made up the overall quality rating (31). Of the nine studies that were rated as weak, one was weak in all categories (30) and the other eight were weak in either four or five of the six categories (1,25,(27)(28)(29)(32)(33)(34). One of the studies that had on overall rating of moderate (31) used an experimental design with randomization but was limited by a small sample size, i.e.…”

“…Two of the studies were in an outpatient pediatric setting (28,34). Seven of the studies targeted physiotherapists only (1,28,29,31,(33)(34)(35) , one study occurred with community mental health professions (unspecified but occupational therapy assumed) (25), one study each targeted occupational therapists only (30) and prosthetists only (27), and one study involved physiotherapists, occupational therapists and speech-language pathologists (32). While nine studies reported various provider characteristics such as age, gender, years of experience, work location, and caseload levels, one study reported only the professional discipline of the providers (33), and one study reported only 'mental health providers' without specifying any further provider characteristics (25).…”

“…There was one randomized controlled trial (31), two controlled before and after studies (29,35) , seven before and after studies (1,25,27,28,30,33,34), and one retrospective cohort study (32). Nine of the eleven studies had an overall quality rating of weak.…”

“…Most often, these characteristics included age and diagnosis. An additional three (29,30,35) provided a general description of the patients (i.e., patients with low back pain), and the remaining four (1, 27, 31, 33) did not include any information on patients.…”

“…There were a range of clinical study settings. For example, one was in outpatient mental health (25), one in both private practices and nursing homes (29), and one in the area of chronic pain (30). Three of the studies covered both acute and community contexts: stroke (31), brain injury (32) and non-specified (33) (i.e.…”