Occupational Therapy for Multiple Sclerosis: Overcoming Barriers to Implementing Best Practices

Article type
Authors
De Coninck L1, Boers A2, Eijssen I3, Bekkering G4, Koen M5, Freeman J6, O'Meara C7, Hynes S8, Kos D9
1Academic Center for General Practice, KU Leuven, Leuven, Belgium
2Rehabilitation Sciences - Occupational Therapy, KU Leuven , Leuven, Belgium
3Amsterdam UMC location Vrije Universiteit Amsterdam, Rehabilitation Medicine, MS Center Amsterdam; Research institutes Amsterdam Neuroscience, Amsterdam Movement Sciences, Amsterdam Public Health, Amsterdam, Netherlands
4Belgian Centre for Evidence-Based Medicine, Cochrane Belgium, Leuven, Belgium; Academic Centre for General Practice, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
5MS Telefoon, MS Vereniging, Den Dolder, Netherlands
6School of Health Professions, University of Plymouth, Peninsula Allied Health Centre, Plymouth, UK
7School of Nursing & Midwifery, University of Galway, Galway, Ireland
8Discipline of Occupational Therapy, School of Health Sciences, University of Galway, Galway, Ireland
9Rehabilitation Sciences - Occupational Therapy, KU Leuven , Leuven, Belgium; Rehabilitation Research, National Multiple Sclerosis Center, Melsbroek, Belgium
Abstract
"Background: To facilitate successful implementation of evidence into occupational therapy (OT) clinical practice, it is important to assess the facilitators and barriers for this process.

Objective: To identify key determinants for implementing occupational therapy evidence into multiple sclerosis practice.

Method: Through an explorative literature review in five databases (Pubmed, Cinahl, Embase, Eric, OTDbase) and a clinician survey, barriers and facilitators related to the implementation of OT evidence, specific to MS are explored, and strategies to transform barriers into facilitators are outlined.

Results: Of 303 screened titles, none explored implementing evidence specifically for OT in multiple sclerosis. Instead, we selected indirect evidence, implementing evidence on OT for any indication. When looking at the broader focus on using OT evidence in general practice, we found relevant indirect evidence (n=11), which is categorized in barriers and facilitators related to innovation, individual professional, patient, social context, organizational context, and economic and political context. Subsequently, a survey was developed based on the identified barriers and facilitators and on existing questionnaires [Evidence Based Practice Questionnaire and short version of Evidence-based Practice Implementation Scales (competencies, beliefs, attitudes- organisations, implementation, self-efficacy)]. The survey was launched in Spring 2024 among occupational therapists working with people with MS. This survey will contextualize the findings of the explorative review to the OT practice with people with MS and allows for prioritizing important implementation determinants and selecting pertinent strategies to address these through a newly developed implementation plan.

Conclusion: This study represents a first step in the implementation plan, striving for the empowerment of occupational therapists to enhance their knowledge and align their practices with evidence-based interventions, strategically bridging the gap between research findings and practical, real-world application of effective and impactful approaches in occupational therapy settings for individuals with multiple sclerosis.

Funding: Elizabeth Casson Trust, UK; Evidence Synthesis Ireland, Ireland "