Evaluating the implementation of personalised outcomes forecasts to optimise supervised exercise therapy in patients with intermittent claudication in the Netherlands: a multimethods study
Background To support the optimisation of supervised exercise therapy (SET) in patients with intermittent claudication, we developed personalised outcomes forecasts (POFs), which visualise estimated walking distance and quality of life for individual patients. The POFs may enable healthcare professi...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2024-03-01
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| Series: | BMJ Open Quality |
| Online Access: | https://bmjopenquality.bmj.com/content/13/1/e002594.full |
| _version_ | 1827168036474322944 |
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| author | Philip J van der Wees Anneroos Sinnige Thomas J Hoogeboom Laura H M Marcellis Katrien M Rutgers Andrew Kittelson Steffie Spruijt Joep A W Teijink |
| author_facet | Philip J van der Wees Anneroos Sinnige Thomas J Hoogeboom Laura H M Marcellis Katrien M Rutgers Andrew Kittelson Steffie Spruijt Joep A W Teijink |
| author_sort | Philip J van der Wees |
| collection | DOAJ |
| description | Background To support the optimisation of supervised exercise therapy (SET) in patients with intermittent claudication, we developed personalised outcomes forecasts (POFs), which visualise estimated walking distance and quality of life for individual patients. The POFs may enable healthcare professionals, such as physical and exercise therapists, to improve shared decision-making and patient outcomes.Objectives To assess differences in patient outcomes (functional walking distance, maximal walking distance and health-related quality of life) and the level of shared decision-making before and after the implementation of POFs in the conservative treatment of patients with intermittent claudication.Methods An interrupted time series design was used to compare preimplementation and postimplementation differences on patient outcomes. Using routinely collected data, differences from baseline to 6 months were compared between patients before and patients after the implementation. To compare levels of shared decision-making, we conducted observations of initial consults within a sample of physical or exercise therapists both before and after the implementation. Audiorecords of observations were scored on shared decision-making using the OPTION-5 instrument.Results Differences in improvements between patients with whom POFs were discussed (n=317) and patients before the implementation of POFs (n=721) did not reach statistical significance for both functional walking distance (experimental vs. control=+23%, p=0.11) and maximal walking distance (experimental vs. control=+21%, p=0.08). For health-related quality of life, the POFs-informed patients showed a statistically significant greater improvement of 4% (p=0.04). Increased levels of shared decision-making were observed in postimplementation consults (n=20) when compared with preimplementation consults (n=36), as the median OPTION-5 total score showed a statistically significant increase from 45 to 55 points (p=0.01).Conclusions Integrating POFs into daily practice of SET for patients with intermittent claudication could assist in improving health-related quality of life and enhancing patient involvement. Using POFs did not result in statistically significant different improvements between groups on walking distances.Trial registration number NL8838. |
| first_indexed | 2024-03-07T23:25:47Z |
| format | Article |
| id | doaj.art-7f3db47a20224527aa07de3e226cd721 |
| institution | Directory Open Access Journal |
| issn | 2399-6641 |
| language | English |
| last_indexed | 2025-03-21T02:13:48Z |
| publishDate | 2024-03-01 |
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| series | BMJ Open Quality |
| spelling | doaj.art-7f3db47a20224527aa07de3e226cd7212024-08-02T17:35:10ZengBMJ Publishing GroupBMJ Open Quality2399-66412024-03-0113110.1136/bmjoq-2023-002594Evaluating the implementation of personalised outcomes forecasts to optimise supervised exercise therapy in patients with intermittent claudication in the Netherlands: a multimethods studyPhilip J van der Wees0Anneroos Sinnige1Thomas J Hoogeboom2Laura H M Marcellis3Katrien M Rutgers4Andrew Kittelson5Steffie Spruijt6Joep A W Teijink7Radboud university medical center, IQ Health science department, Nijmegen, The NetherlandsDepartment of Surgery, Catharina Hospital, Eindhoven, The NetherlandsRadboud university medical center, IQ Health science department, Nijmegen, The NetherlandsRadboud university medical center, IQ Health science department, Nijmegen, The NetherlandsPhysique Preventiecentrum B.V, Arnhem, The NetherlandsSchool of Physical Therapy and Rehabilitation Science, University of Montana, Missoula, Montana, USAChronisch ZorgNet, Eindhoven, The NetherlandsDepartment of Vascular Surgery, Catharina Hospital, Eindhoven, The NetherlandsBackground To support the optimisation of supervised exercise therapy (SET) in patients with intermittent claudication, we developed personalised outcomes forecasts (POFs), which visualise estimated walking distance and quality of life for individual patients. The POFs may enable healthcare professionals, such as physical and exercise therapists, to improve shared decision-making and patient outcomes.Objectives To assess differences in patient outcomes (functional walking distance, maximal walking distance and health-related quality of life) and the level of shared decision-making before and after the implementation of POFs in the conservative treatment of patients with intermittent claudication.Methods An interrupted time series design was used to compare preimplementation and postimplementation differences on patient outcomes. Using routinely collected data, differences from baseline to 6 months were compared between patients before and patients after the implementation. To compare levels of shared decision-making, we conducted observations of initial consults within a sample of physical or exercise therapists both before and after the implementation. Audiorecords of observations were scored on shared decision-making using the OPTION-5 instrument.Results Differences in improvements between patients with whom POFs were discussed (n=317) and patients before the implementation of POFs (n=721) did not reach statistical significance for both functional walking distance (experimental vs. control=+23%, p=0.11) and maximal walking distance (experimental vs. control=+21%, p=0.08). For health-related quality of life, the POFs-informed patients showed a statistically significant greater improvement of 4% (p=0.04). Increased levels of shared decision-making were observed in postimplementation consults (n=20) when compared with preimplementation consults (n=36), as the median OPTION-5 total score showed a statistically significant increase from 45 to 55 points (p=0.01).Conclusions Integrating POFs into daily practice of SET for patients with intermittent claudication could assist in improving health-related quality of life and enhancing patient involvement. Using POFs did not result in statistically significant different improvements between groups on walking distances.Trial registration number NL8838.https://bmjopenquality.bmj.com/content/13/1/e002594.full |
| spellingShingle | Philip J van der Wees Anneroos Sinnige Thomas J Hoogeboom Laura H M Marcellis Katrien M Rutgers Andrew Kittelson Steffie Spruijt Joep A W Teijink Evaluating the implementation of personalised outcomes forecasts to optimise supervised exercise therapy in patients with intermittent claudication in the Netherlands: a multimethods study BMJ Open Quality |
| title | Evaluating the implementation of personalised outcomes forecasts to optimise supervised exercise therapy in patients with intermittent claudication in the Netherlands: a multimethods study |
| title_full | Evaluating the implementation of personalised outcomes forecasts to optimise supervised exercise therapy in patients with intermittent claudication in the Netherlands: a multimethods study |
| title_fullStr | Evaluating the implementation of personalised outcomes forecasts to optimise supervised exercise therapy in patients with intermittent claudication in the Netherlands: a multimethods study |
| title_full_unstemmed | Evaluating the implementation of personalised outcomes forecasts to optimise supervised exercise therapy in patients with intermittent claudication in the Netherlands: a multimethods study |
| title_short | Evaluating the implementation of personalised outcomes forecasts to optimise supervised exercise therapy in patients with intermittent claudication in the Netherlands: a multimethods study |
| title_sort | evaluating the implementation of personalised outcomes forecasts to optimise supervised exercise therapy in patients with intermittent claudication in the netherlands a multimethods study |
| url | https://bmjopenquality.bmj.com/content/13/1/e002594.full |
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