Current use of PROMs and factors associated with their use in patients with nonspecific low back pain

Abstract Objective Patient‐related outcome measures (PROMs) can guide clinicians in providing evidence‐based treatment and have the potential to empower patients, support clinical decision making, and improve quality of care. In order to make the information coming from PROMs useful, it is important...

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Main Authors: Marjon Brinkman, Di‐Janne Barten, Martijn Pisters, Robert Verheij
Format: Article
Language:English
Published: Wiley 2019-10-01
Series:Learning Health Systems
Subjects:
Online Access:https://doi.org/10.1002/lrh2.10194
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author Marjon Brinkman
Di‐Janne Barten
Martijn Pisters
Robert Verheij
author_facet Marjon Brinkman
Di‐Janne Barten
Martijn Pisters
Robert Verheij
author_sort Marjon Brinkman
collection DOAJ
description Abstract Objective Patient‐related outcome measures (PROMs) can guide clinicians in providing evidence‐based treatment and have the potential to empower patients, support clinical decision making, and improve quality of care. In order to make the information coming from PROMs useful, it is important to know to what extent the use of PROMs is biased in any way. Therefore, we assessed (a) the current level of use of PROMs among primary care physiotherapists and (b) which factors on the patient level, therapist level, and primary care practice level are associated with the use of PROMs in patients with nonspecific low back pain (LBP). Design An observational study based on electronic health record data recorded routinely in Nivel Primary Care Database. Participants A total of 2916 patients aged 18 years or older with nonspecific LBP consulting a primary care physiotherapist. Methods Multilevel logistic regression analyses were used to identify factors at the level of the patient, physiotherapist, and primary care practice, which may affect the use of PROMs. Results PROMs were used in 46% of the patients, by 72% of the physiotherapists, and in 71% of the physiotherapy practices. None of the included independent variables were associated with the use of PROMs. Only 1% of the variance was explained by the final model. Conclusion This study shows that the use of PROMs is mostly dependent on characteristics of patients. However, we did not succeed in identifying characteristics of patients that are responsible for that. This could mean that therapists randomly choose patients for PROMs or that there is some other unmeasured patient characteristic determining the use of PROMs. The former explanation implies no systematic bias in the information resulting from PROMs. More research is needed to examine possible related factors to improve implementation and a more frequent use of PROMs in the future.
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spelling doaj.art-1153e6ab1ae345ceb19047b83fc521ae2022-12-21T22:32:24ZengWileyLearning Health Systems2379-61462019-10-0134n/an/a10.1002/lrh2.10194Current use of PROMs and factors associated with their use in patients with nonspecific low back painMarjon Brinkman0Di‐Janne Barten1Martijn Pisters2Robert Verheij3Nivel Primary Care Database (Nivel‐PCD) Netherlands Institute for Health Services Research (NIVEL) Utrecht NetherlandsResearch Group Innovation of Human Movement Care University of Applied Sciences Utrecht Utrecht NetherlandsDepartment of Health Innovation and Technology Fontys University of Applied Sciences Eindhoven NetherlandsNivel Primary Care Database (Nivel‐PCD) Netherlands Institute for Health Services Research (NIVEL) Utrecht NetherlandsAbstract Objective Patient‐related outcome measures (PROMs) can guide clinicians in providing evidence‐based treatment and have the potential to empower patients, support clinical decision making, and improve quality of care. In order to make the information coming from PROMs useful, it is important to know to what extent the use of PROMs is biased in any way. Therefore, we assessed (a) the current level of use of PROMs among primary care physiotherapists and (b) which factors on the patient level, therapist level, and primary care practice level are associated with the use of PROMs in patients with nonspecific low back pain (LBP). Design An observational study based on electronic health record data recorded routinely in Nivel Primary Care Database. Participants A total of 2916 patients aged 18 years or older with nonspecific LBP consulting a primary care physiotherapist. Methods Multilevel logistic regression analyses were used to identify factors at the level of the patient, physiotherapist, and primary care practice, which may affect the use of PROMs. Results PROMs were used in 46% of the patients, by 72% of the physiotherapists, and in 71% of the physiotherapy practices. None of the included independent variables were associated with the use of PROMs. Only 1% of the variance was explained by the final model. Conclusion This study shows that the use of PROMs is mostly dependent on characteristics of patients. However, we did not succeed in identifying characteristics of patients that are responsible for that. This could mean that therapists randomly choose patients for PROMs or that there is some other unmeasured patient characteristic determining the use of PROMs. The former explanation implies no systematic bias in the information resulting from PROMs. More research is needed to examine possible related factors to improve implementation and a more frequent use of PROMs in the future.https://doi.org/10.1002/lrh2.10194patient‐reported outcome measuresPROMsphysiotherapyquality of carelow back painoutcome measures
spellingShingle Marjon Brinkman
Di‐Janne Barten
Martijn Pisters
Robert Verheij
Current use of PROMs and factors associated with their use in patients with nonspecific low back pain
Learning Health Systems
patient‐reported outcome measures
PROMs
physiotherapy
quality of care
low back pain
outcome measures
title Current use of PROMs and factors associated with their use in patients with nonspecific low back pain
title_full Current use of PROMs and factors associated with their use in patients with nonspecific low back pain
title_fullStr Current use of PROMs and factors associated with their use in patients with nonspecific low back pain
title_full_unstemmed Current use of PROMs and factors associated with their use in patients with nonspecific low back pain
title_short Current use of PROMs and factors associated with their use in patients with nonspecific low back pain
title_sort current use of proms and factors associated with their use in patients with nonspecific low back pain
topic patient‐reported outcome measures
PROMs
physiotherapy
quality of care
low back pain
outcome measures
url https://doi.org/10.1002/lrh2.10194
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