Planning a Clinical Practice Guideline Revision for a Core Set of Outcome Measures in Adults Undergoing Neurologic Physical Therapy, Part 2: Determining Stakeholders' Uptake and Recommendations
TL;DR
Despite reported barriers to clinical implementation of CPGs, survey respondents overwhelmingly reported gaining knowledge and changing practice in response to the 2018 CPG, and recommended the revision include measures to capture both higher and lower‐level activities.
Abstract
ABSTRACT Objective To determine the uptake and recommendations for revision of the 2018 Clinical Practice Guideline (CPG): Core Set Outcome Measures for Adults with Neurologic Conditions Undergoing Rehabilitation. Design Online Survey. Setting Online with participants from multiple settings. Participants Licensed physical therapists (PT) or physical therapist assistants (PTA) or a non‐PT supervisor of PTs and/or PTAs. Interventions N/A. Main Outcome Measures An online survey was developed to determine respondents' knowledge, perceived benefits, challenges, gaps, and modifications made to the 2018 CPG as well as to ascertain respondents' recommendations for the CPG revision. Data were analyzed descriptively by respondent role (clinician, educator/researcher, or supervisor/manager). Respondents' narrative comments were coded into 3 categories: implementation challenges, modifications, and revision recommendations. Results Four hundred and ninety‐seven individuals accessed the survey. Seventy‐six percent (379) completed 80% of items. Two hundred and forty‐one (63.5%) identified their primary role as clinician. The majority (99%) agreed they understood the purpose, process and recommendations of the CPG; 70% agreed that the CPG changed their practice. More than 70% agreed the CPG‐recommended Core Set provided a comprehensive assessment of balance and gait. Narrative comments revealed implementation challenges including lack of time, space and buy‐in. Clinicians made modifications to the Core Set including using fewer measures, adding other measures and modifying measures (e.g. changing distances, providing patient assistance). Suggestions for the CPG revision included adding higher and lower‐level measures. Conclusions Despite reported barriers to clinical implementation of CPGs, survey respondents overwhelmingly reported gaining knowledge and changing practice in response to the 2018 CPG. They recommended the revision include measures to capture both higher‐ and lower‐level activities. Future CPG developers should consider assessing uptake and recommendations to help guide CPG revisions.