Guideline-based development and practice test of quality indicators for physiotherapy care in patients with neck pain.

Guideline-based development and practice test of quality indicators for physiotherapy care in patients with neck pain.

Not much is known at this time about the quality of physiotherapy care for patients with musculoskeletal pain. Neck pain was used as an example in this study. The aim was to develop a set of quality indicators, including a practice test.

A systematic method was used to develop potential process and outcome indicators. An expert and user panel was used to appraise the potential quality indicators regarding clarity, relevancy, feasibility, acceptability and improvement potential. An invitation to participate in the practice test was sent to physiotherapy practices. The resulting algorithm was used to calculate the degree to which physiotherapists met these indicators (0-100%). Differences in valid outcomes were tested for significance (Student’s t-test; α = 0.05) and compared with established values for clinical relevance [minimal clinically important change (MCIC)].

Of the 106 potential participants from 27 practices, 38 physiotherapists (35.8%) submitted data on 96 patients with non-specific neck pain. On average, the participating physiotherapists showed a 55.6% adherence to process indicators with a considerable variation in scores per step of the clinical reasoning process. The outcomes for ‘pain’, ‘headache’ and ‘daily functioning’ were substantially better compared with baseline, and the mean differences were above established values for MCICs.

The authors of the study cautiously concluded that a systematic approach is a valuable means to develop a preliminary set of process and outcome indicators for physiotherapy care for patients with non-specific neck pain, and a practice test should be an intrinsic part of such a systematic approach as it provides useful data on the primary attributes of the set indicators.

Neck Pain

Out of all 291 conditions studied in the Global Burden of Disease 2010 Study, neck pain ranked 4th highest in terms of disability and 21st in terms of overall burden.

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