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Implementing Patient-Reported Outcome Measures in Outpatient Rehabilitation Settings: A Systematic Review of Facilitators and Barriers Using the Consolidated Framework for Implementation Research.

Authors
  • Briggs, Matthew S1
  • Rethman, Katherine Kozak2
  • Crookes, Justin3
  • Cheek, Fern4
  • Pottkotter, Kristy2
  • McGrath, Shana5
  • DeWitt, John6
  • Harmon-Matthews, Lindsay E7
  • Quatman-Yates, Catherine C8
  • 1 Sports Medicine Research Institute, The Ohio State University Wexner Medical Center, Jameson Crane Sports Medicine Institute, Columbus, Ohio; OSU Sports Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio; Department of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, Ohio. Electronic address: [email protected]
  • 2 Sports Medicine Research Institute, The Ohio State University Wexner Medical Center, Jameson Crane Sports Medicine Institute, Columbus, Ohio; OSU Sports Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio.
  • 3 Division of Physical Therapy, School of Health and Rehabilitation Sciences, College of Medicine Ohio State University, Columbus, Ohio.
  • 4 Health Sciences Library, The Ohio State University, Columbus, Ohio.
  • 5 OSUWMC Outpatient Rehabilitation, The Ohio State University Wexner Medical Center, Columbus, Ohio.
  • 6 OSU Sports Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio; Division of Physical Therapy, School of Health and Rehabilitation Sciences, College of Medicine Ohio State University, Columbus, Ohio.
  • 7 OSU Sports Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio; OSUWMC Outpatient Rehabilitation, The Ohio State University Wexner Medical Center, Columbus, Ohio.
  • 8 Sports Medicine Research Institute, The Ohio State University Wexner Medical Center, Jameson Crane Sports Medicine Institute, Columbus, Ohio; Division of Physical Therapy, School of Health and Rehabilitation Sciences, College of Medicine Ohio State University, Columbus, Ohio.
Type
Published Article
Journal
Archives of physical medicine and rehabilitation
Publication Date
Oct 01, 2020
Volume
101
Issue
10
Pages
1796–1812
Identifiers
DOI: 10.1016/j.apmr.2020.04.007
PMID: 32416149
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

This systematic review examines the facilitators and barriers to the use of patient-reported outcome measures (PROMs) in outpatient rehabilitation settings and provides strategies to improve care to maximize patient outcomes. Eleven databases were systematically searched from November 2018 to May 2019. Two reviewers independently assessed articles based on the following inclusion criteria: English text, evaluate barriers and facilitators, include PROMs, and occur in an outpatient rehabilitation setting (physical therapy, occupational therapy, speech language pathology, or athletic training). Of the 10,164 articles initially screened, 15 articles were included in this study. Data were extracted from the selected articles by 2 independent reviewers and put into an extraction template and into the Consolidated Framework for Implementation Research (CFIR) model. The Appraisal Tool for Cross-Sectional Studies (AXIS) was conducted on each study to assess study design, risk of bias, and reporting quality of the eligible studies. Ten studies were identified as high quality, according to the AXIS. Based on the CFIR model, the top barriers identified focused on clinician training and time in the implementation process, lack of recognized value and knowledge at the individual level, lack of access and support in the inner setting, and inability of patients to complete PROMs in the intervention process. Facilitators were identified as education in the implementation process, support and availability of PROMs in the inner setting, and recognized value at the individual level. More barriers than facilitators have been identified, which is consistent with PROM underuse. Clinicians and administrators should find opportunities to overcome the barriers identified and leverage the facilitators to improve routine PROM use and maximize patient outcomes. Copyright © 2020 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

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