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Abstract Number: 2109

Quality Indicators For Physical Therapy Management In Hip and Knee Osteoarthritis and Rheumatoid Arthritis

Wilfred FH Peter1,2, Emalie Hurkmans3, Philip van der Wees4, Erik Hendriks5, Rob de Bie5, Leti van Bodegom-Vos6 and Theodora P.M. Vliet Vlieland7, 1Departmentof Orthopaedics, Leiden University Medical Center, Leiden, Netherlands, 2Amsterdam Rehabilitation Research Center, Reade, centre for rehabilitation and rheumatology, Amsterdam, Netherlands, 3Section Physiotherapy, University of Applied Sciences, Vienna, Austria, 4IQ Healthcare, Radboud University, Nijmegen, Netherlands, 5Centre for Evidence Based Physiotherapy, University of Maastricht, Maastricht, Netherlands, 6Department of Medical Decision Making, Leiden University Medical Center, Leiden, Netherlands, 7Department of Orthopaedics, Leiden University Medical Center, Leiden, Netherlands

Meeting: 2013 ACR/ARHP Annual Meeting

Keywords: Osteoarthritis, physical therapy and rheumatoid arthritis (RA), Quality Indicators

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Session Information

Title: ARHP Orthopedics, Low Back Pain and Rehabilitation: Rehabilitation Sciences

Session Type: Abstract Submissions (ARHP)

Background/Purpose:

Physical therapy is recommended in several guidelines on the management of osteoarthritis and rheumatoid arthritis.  Currently, no specific quality indicators for physical therapy in patients with Osteoarthritis and Rheumatoid Arthritis are available. The aim of this study was to develop quality indicators for the physical therapy management of patients with Osteoarthritis and Rheumatoid Arthritis

Methods:

The first concept quality indicators were derived from the recommendations included in two recent Dutch physical therapy evidence based practice guidelines for Osteoarthritis and Rheumatoid Arthritis, according to guidelines for the development of quality indicators.

Two multidisciplinary expert group (Osteoarthritis and Rheumatoid Arthritis) of 19 persons were composed containing  patients; 1 patient representative from the Dutch Arthritis association; physical therapists; general practitioners; rheumatologists; orthopaedic surgeon; rehabilitation physician; occupational therapist; and researchers. Using Delphi rounds, the expert group could suggest other topics for the set of indicators, and then scored all topics with respect to relevance (score range 0=not at all relevant to 9=extremely relevant) and feasibility of measuring. Potential topics were selected if a score of >6 was obtained by >75% of the experts regarding aspect representing good quality of physical therapy care. Indicators with scores 5 or 6 were again entered into a Delphi round and selected  for the final set based on comments of the expert arguments.  Selected quality indicators were then combined and reformulated by the project group.

Results:

In Osteoarthritis an initial set of 23 indicators were selected. Based on relevance score > 6  eleven indicators were first selected. Based on experts’ comments 3 indicators were rejected, and the remaining 9 indicators were partly combined  and  reformulated  into 6 items, resulting in a final set of 17 indicators  for physical therapy in Osteoarthritis.

For physical therapy in Rheumatoid Arthritis an initial set of 27 indicators were selected. Based on relevance sore > 6 ten indicators were first selected. After comments of the experts 3 items were rejected, and 14  items were partly combined and reformulated into 7 indicators for the final set, resulting in a final set of 17 quality indicators for physical therapy in Rheumatoid Arthritis.

Both quality indicator sets containing 16 process indicators (regarding initial assessment, treatment and evaluation) and one outcome indicator.

The majority of multidisciplinary experts in Osteoarthritis and Rheumatoid Arthritis stated the final indicators were measurable, and data should preferably conducted by consulting (electronic) patient files.

Conclusion:

Two sets of 17 quality indicators for physical therapy management in Osteoarthritis and Rheumatoid Arthritis were developed and made suitable to measure quality of physical therapy care in daily clinical practice. The clinimetric properties reliability and discriminative power need to be investigated in future research.


Disclosure:

W. F. Peter,
None;

E. Hurkmans,
None;

P. van der Wees,
None;

E. Hendriks,
None;

R. de Bie,
None;

L. van Bodegom-Vos,
None;

T. P. M. Vliet Vlieland,
None.

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