Agreement between telehealth and in-person assessment of patients with chronic musculoskeletal conditions presenting to an advanced-practice physiotherapy screening clinic

被引:63
作者
Cottrell, Michelle A. [1 ,2 ]
O'Leary, Shaun P. [1 ,2 ]
Swete-Kelly, Patrick [2 ]
Elwell, Bula [3 ]
Hess, Sally [2 ]
Litchfield, Mary-Ann [2 ]
McLoughlin, Ian [3 ]
Tweedy, Rebecca [2 ]
Raymer, Maree [4 ,5 ]
Hill, Anne J. [1 ]
Russell, Trevor G. [1 ]
机构
[1] Univ Queensland, Sch Hlth & Rehabil Sci, Therapies Bldg 84A, Brisbane, Qld 4072, Australia
[2] Royal Brisbane & Womens Hosp, Physiotherapy Dept, Butterfield St, Brisbane, Qld 4029, Australia
[3] Ipswich Hosp, Physiotherapy Dept, Chelmsford Ave, Ipswich, Qld 4305, Australia
[4] Royal Brisbane & Womens Hosp, State Wide Neurosurg & Orthopaed Physiotherapy Sc, Butterfield St, Herston, Qld 4029, Australia
[5] Royal Brisbane & Womens Hosp, Multidisciplinary Serv, Butterfield St, Herston, Qld 4029, Australia
关键词
ORTHOPEDIC SURGEON; TELEREHABILITATION; DISORDERS; DETERMINANTS; RELIABILITY; DIAGNOSIS; VALIDITY; SERVICE; ROLES;
D O I
10.1016/j.msksp.2018.09.014
中图分类号
R49 [康复医学];
学科分类号
100215 ;
摘要
Objective: To determine the level of agreement between a telehealth and in-person assessment of a representative sample of patients with chronic musculoskeletal conditions referred to an advanced-practice physiotherapy screening clinic. Design: Repeated-measures study design. Participants: 42 patients referred to the Neurosurgical & Orthopaedic Physiotherapy Screening Clinic (Queensland, Australia) for assessment of their chronic lumbar spine, knee or shoulder condition. Intervention: Participants underwent two consecutive assessments by different physiotherapists within a single clinic session. In-person assessments were conducted as per standard clinical practice. Telehealth assessments took place remotely via videoconferencing. Six Musculoskeletal Physiotherapists were paired together to perform both assessment types. Main outcome measures: Clinical management decisions including (i) recommended management pathways, (ii) referral to allied health professions, (iii) clinical diagnostics, and (iv) requirement for further investigations were compared using reliability and agreement statistics. Results: There was substantial agreement (83.3%; 35/42 cases) between in-person and telehealth assessments for recommended management pathways. Moderate to near perfect agreement (AC1 = 0.58-0.9) was reached for referral to individual allied health professionals. Diagnostic agreement was 83.3% between the two delivery mediums, whilst there was substantial agreement (81%; AC1 = 0.74) when requesting further investigations. Overall, participants were satisfied with the telehealth assessment. Conclusion: There is a high level of agreement between telehealth and in-person assessments with respect to clinical management decisions and diagnosis of patients with chronic musculoskeletal conditions managed in an advanced-practice physiotherapy screening clinic. Telehealth can be considered as a viable and effective medium to assess those patients who are unable to attend these services in person.
引用
收藏
页码:99 / 105
页数:7
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