Article type
Abstract
Background
Remote health care has been a focal point in physiotherapy since the onset of the COVID-19 pandemic. Although many Dutch physiotherapists experimented with remote health care during the pandemic, its usage has diminished since then. This represents a missed opportunity given the potential of remote health care in enhancing quality of care and reducing costs. To effectively offer remote physiotherapy, an evidence-based guideline is important. However, implementing remote physiotherapy heavily depends on patient- and context-specific factors, making qualitative research methods essential.
Objectives
To develop an evidence-based guideline for remote physiotherapy by making use of clinical guideline methodology in combination with qualitative research
Methods
The guideline development followed international standards based on AGREE II and the GRADE methodology. Clinical questions were answered through systematic literature reviews, and prior to the evidence-to-decision process, qualitative research was conducted to systematically map patient- and context-specific factors. Semistructured interviews with physiotherapists and patients were undertaken. The interview topics were based on qualitative studies as identified in the systematic review and focused on knowledge gaps and context-specific factors. Results of the interviews were transcribed, coded, and grouped into categories and themes. The findings, along with literature conclusions, were presented to the guideline panel prior to the evidence-to-decision process.
Results
A literature review on the effectiveness of remote health care compared with physical care was conducted. As expected, the evidence certainty was very low, and no significant differences could be demonstrated. For the qualitative research, 8 physiotherapists and 7 patients were interviewed. The guideline panel utilized these results to enhance the evidence-to-decision process, particularly in mapping patient preferences, health equity, costs, and feasibility. The combination of scientific literature and interviews resulted in a set of highly practical evidence-based recommendations for delivering remote physiotherapy.
Conclusions
The addition of qualitative research has led to a highly practical guideline. We believe that this approach holds significant value, especially in topics where scientific literature does not directly align with the clinical question and where patient- and context-specific factors play a crucial role. In the future, this approach could be chosen more frequently in the development of evidence-based recommendations.
Remote health care has been a focal point in physiotherapy since the onset of the COVID-19 pandemic. Although many Dutch physiotherapists experimented with remote health care during the pandemic, its usage has diminished since then. This represents a missed opportunity given the potential of remote health care in enhancing quality of care and reducing costs. To effectively offer remote physiotherapy, an evidence-based guideline is important. However, implementing remote physiotherapy heavily depends on patient- and context-specific factors, making qualitative research methods essential.
Objectives
To develop an evidence-based guideline for remote physiotherapy by making use of clinical guideline methodology in combination with qualitative research
Methods
The guideline development followed international standards based on AGREE II and the GRADE methodology. Clinical questions were answered through systematic literature reviews, and prior to the evidence-to-decision process, qualitative research was conducted to systematically map patient- and context-specific factors. Semistructured interviews with physiotherapists and patients were undertaken. The interview topics were based on qualitative studies as identified in the systematic review and focused on knowledge gaps and context-specific factors. Results of the interviews were transcribed, coded, and grouped into categories and themes. The findings, along with literature conclusions, were presented to the guideline panel prior to the evidence-to-decision process.
Results
A literature review on the effectiveness of remote health care compared with physical care was conducted. As expected, the evidence certainty was very low, and no significant differences could be demonstrated. For the qualitative research, 8 physiotherapists and 7 patients were interviewed. The guideline panel utilized these results to enhance the evidence-to-decision process, particularly in mapping patient preferences, health equity, costs, and feasibility. The combination of scientific literature and interviews resulted in a set of highly practical evidence-based recommendations for delivering remote physiotherapy.
Conclusions
The addition of qualitative research has led to a highly practical guideline. We believe that this approach holds significant value, especially in topics where scientific literature does not directly align with the clinical question and where patient- and context-specific factors play a crucial role. In the future, this approach could be chosen more frequently in the development of evidence-based recommendations.