Characteristics, course and outcome of patients receiving physiotherapy in primary health care in Norway: design of a longitudinal observational project

Abstract

BackgroundPhysiotherapists (PTs) in primary health care manage patients with large variation in medical diagnosis, age, functional status, disability and prognosis. Lack of knowledge and systematically collected data from patients treated by PTs in primary health care has prompted this longitudinal observational physiotherapy project. This paper aims to describe a method for developing a database of patients managed by PTs in primary health care, with the main purpose to study patients’ characteristics, treatment courses and prognostic factors for favourable outcome.MethodsThis is a longitudinal observational project, following patients through their physiotherapy treatment periods in primary health care in Norway and until one year after inclusion. The project involves both private practitioners and municipally employed PTs working in primary health care in nine municipalities in Norway. The patients are recruited to three different cohorts depending on age and whether they are referred to a private practitioner or a municipally employed PT. All data are recorded electronically, transferred and stored securely. For all patients we have included extensive questionnaires to obtain information about demographics, disability and function, pain-related variables, psychosocial factors, treatments and evaluation of treatment as well as response to clinical tests. The PTs have access to use their own patients’ data. We have also prepared for linkage to national patient registers and data collected in population-based studies to be able to gather further important data.DiscussionThis project will have important implications for physiotherapy services in primary health care. The database contains more than 3000 patients, and data collection is ongoing. Data collected so far suggest that the patients included are representative of the larger population of patients treated by private practitioners or municipally employed PTs in Norway. This large scale prospective physiotherapy project will provide knowledge about the patient groups, applied treatments and short- and long-term outcome of the patients.Trial registrationClinicalTrials.gov Identifier: NCT03626389. Registered on August 13th 2018 (retrospectively registered).Electronic supplementary materialThe online version of this article (10.1186/s12913-018-3729-y) contains supplementary material, which is available to authorized users.

Patient characteristics in three different working models of home based physiotherapy: a longitudinal observational study in primary health care in Norway

“…Reasons for exclusion were reduced cognitive function incapable of giving consent or the PT not being able to reach the next of kin, language barriers for non-Norwegian speaking patients and ethical concerns for patients receiving palliative care. We have previously reported that sex and age distribution of adult and older patients included in FYSIOPRIM were comparable to those not included, although a higher proportion of non-included patients were living in institutions and more often referred because of geriatrics/functional deterioration (14). As a result, our sample may have had better physical performance compared with the broad spectrum of patients receiving home based physiotherapy.…”

“…Through the Research program for Physiotherapy in Primary Health Care, the FYSIOPRIM, a set of standardized methods and tools have been developed, enabling studies of clinical courses for patients receiving primary care physiotherapy (14). The present study is a longitudinal observational study of adults and older patients receiving physiotherapy, mainly home based, in Trondheim Municipality, which is located in the middle part of Norway.…”

“…Data collection included self-report questionnaires and clinical tests at baseline and follow-up (14). In collaboration, the patient and the PT agreed on the main treatment goal and plan for treatment, which were evaluated at follow-up, either at the end of treatment or six months after baseline for those who continued to receive physiotherapy.…”

“…However, we did not find any baseline differences in demographic and clinical characteristics between those with and without complete follow-up data, except complete cases in the regular physiotherapy group had higher SPPB scores than patients missing data at follow-up. As the present study relied on assessments by up to 55 different PTs during clinical encounters with the patients (14), inter-rater reliability bias may have occurred, as well as potential desirability bias as all patient-reported outcome measures were registered with the PT present. We assume, however, that the inter-rater reliability bias was low, because the SPPB is already an integrated part of the physiotherapy practice and most PTs are experienced users of the instrument.…”

Profile Of Children Referred To Primary Health Care Physiotherapy: A Longitudinal Observational Study In Norway

“…The parents of all eligible children were asked to participate prior to or during the rst consultation with the PT. A tablet application was used for electronic data collection, and parents also had the opportunity to answer questionnaires through an e-mail link (12). This study used baseline data registered by the PT and the parents separately and in collaboration and only data registered in collaboration at follow-up, due to a substantial amount of missing parent-reported data at follow-up.…”