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Chiropractors' views on the use of patient-reported outcome measures in clinical practice: A qualitative study

Chiropractors' views on the use of patient-reported outcome measures in clinical practice: A qualitative study
Chiropractors' views on the use of patient-reported outcome measures in clinical practice: A qualitative study

Background: Patient-reported outcome measures (PROMs) are widely available for use in musculoskeletal care. However, there is little research exploring the implementation of PROMs in clinical practice. This qualitative study explored chiropractors' views on PROMs to identify any barriers and facilitators to implementing PROMs in chiropractic care and the training needs of chiropractors regarding the use of PROMs. Methods: A qualitative study of chiropractors' views on PROMs was undertaken as part of a larger project to address the feasibility of conducting a randomised controlled trial of PROM use in chiropractic clinics for patients with low back pain. Contact was made with chiropractors working in chiropractic companies with multiple clinic sites. Semi-structured interviews were conducted with eight chiropractors, either face-to-face at their place of work or over the telephone. The interviews were transcribed verbatim and analysed using thematic analysis. The data were coded inductively by two authors. Results: Chiropractors discussed their knowledge and engagement with PROMs in clinical practice, identifying reasons for their use, such as understanding clinic performance, clinical practice, and research. They also discussed how they used PROMs within their clinical practice and the benefits of using them with individual patients, for example during the consultation, identifying yellow flags, and tracking patient progress. Chiropractors voiced concerns about patient engagement with PROMs, questioning if patients find them burdensome, and the appropriate PROMs to use with patients with pain. Finally, chiropractors acknowledged the organisational barriers and facilitators to using PROMs within their practice, such as busy practices, electronic systems, and use of reception staff. Conclusions: Using participating chiropractors' views of PROMs, the study identified barriers and facilitators to implementing PROMs in chiropractic care, such as clinician knowledge, engagement, and organisational concerns and identified the potential training needs of chiropractors regarding PROMs. The results from the study suggested chiropractors use PROMs with their individual patients, but PROMs should be meaningful to patients and chiropractors to improve engagement.

Clinical practice, Implementation, Musculoskeletal care, Patient-reported outcome measures, Qualitative research
2045-709X
Holmes, Michelle M.
85f53fee-882a-4d6b-9980-c73e5809fc65
Bishop, Felicity L.
1f5429c5-325f-4ac4-aae3-6ba85d079928
Newell, David
f1a21938-9604-4f10-aac2-bb19337a638e
Field, Jonathan
61b0ca4a-3907-4847-b0b5-506e1929fc51
Lewith, George
0fc483fa-f17b-47c5-94d9-5c15e65a7625
Holmes, Michelle M.
85f53fee-882a-4d6b-9980-c73e5809fc65
Bishop, Felicity L.
1f5429c5-325f-4ac4-aae3-6ba85d079928
Newell, David
f1a21938-9604-4f10-aac2-bb19337a638e
Field, Jonathan
61b0ca4a-3907-4847-b0b5-506e1929fc51
Lewith, George
0fc483fa-f17b-47c5-94d9-5c15e65a7625

Holmes, Michelle M., Bishop, Felicity L., Newell, David, Field, Jonathan and Lewith, George (2018) Chiropractors' views on the use of patient-reported outcome measures in clinical practice: A qualitative study. Chiropractic & Manual Therapies, 26 (1). (doi:10.1186/s12998-018-0219-6).

Record type: Article

Abstract

Background: Patient-reported outcome measures (PROMs) are widely available for use in musculoskeletal care. However, there is little research exploring the implementation of PROMs in clinical practice. This qualitative study explored chiropractors' views on PROMs to identify any barriers and facilitators to implementing PROMs in chiropractic care and the training needs of chiropractors regarding the use of PROMs. Methods: A qualitative study of chiropractors' views on PROMs was undertaken as part of a larger project to address the feasibility of conducting a randomised controlled trial of PROM use in chiropractic clinics for patients with low back pain. Contact was made with chiropractors working in chiropractic companies with multiple clinic sites. Semi-structured interviews were conducted with eight chiropractors, either face-to-face at their place of work or over the telephone. The interviews were transcribed verbatim and analysed using thematic analysis. The data were coded inductively by two authors. Results: Chiropractors discussed their knowledge and engagement with PROMs in clinical practice, identifying reasons for their use, such as understanding clinic performance, clinical practice, and research. They also discussed how they used PROMs within their clinical practice and the benefits of using them with individual patients, for example during the consultation, identifying yellow flags, and tracking patient progress. Chiropractors voiced concerns about patient engagement with PROMs, questioning if patients find them burdensome, and the appropriate PROMs to use with patients with pain. Finally, chiropractors acknowledged the organisational barriers and facilitators to using PROMs within their practice, such as busy practices, electronic systems, and use of reception staff. Conclusions: Using participating chiropractors' views of PROMs, the study identified barriers and facilitators to implementing PROMs in chiropractic care, such as clinician knowledge, engagement, and organisational concerns and identified the potential training needs of chiropractors regarding PROMs. The results from the study suggested chiropractors use PROMs with their individual patients, but PROMs should be meaningful to patients and chiropractors to improve engagement.

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More information

Accepted/In Press date: 31 October 2018
e-pub ahead of print date: 18 December 2018
Published date: 18 December 2018
Keywords: Clinical practice, Implementation, Musculoskeletal care, Patient-reported outcome measures, Qualitative research

Identifiers

Local EPrints ID: 427126
URI: https://eprints.soton.ac.uk/id/eprint/427126
ISSN: 2045-709X
PURE UUID: ce201ced-c581-44ae-a6bd-bddd9821098d
ORCID for Michelle M. Holmes: ORCID iD orcid.org/0000-0002-6018-2235
ORCID for Felicity L. Bishop: ORCID iD orcid.org/0000-0002-8737-6662
ORCID for David Newell: ORCID iD orcid.org/0000-0003-1462-3586

Catalogue record

Date deposited: 03 Jan 2019 17:30
Last modified: 10 Dec 2019 01:46

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