PATIENTS SUCCESS CRITERIA AND EXPECTATIONS IN FALLS REHABILITATION
Author(s)
Sergio Romero, PhD, Research Health ScienceDepartment of Veterans Affairs, Gainesville, FL, USA
OBJECTIVES Performance-based instruments commonly used in clinical settings often do not capture important aspects of the patient's health experience. Therefore, the primary aim of this study was to use a patient-reported outcomes (PRO) questionnaire to investigate patient's success criteria and expectations when receiving rehabilitation services related to falls. METHODS A group of patients (N=50, age = 55+) receiving physical therapy services were enrolled. Inclusion criteria consisted of: community dwellers with a history of falling, ability to walk 20ft, and Mini-Mental State Exam score >24. The Patient's Perspective Outcome Questionnaire (PPOQ) was administered at the initial physical therapy evaluation. PPOQ assesses current levels, success criteria and expected levels for a number of health domains including: mobility, self-care, interactions with people, community/social life, energy/drive, mental function, emotional distress, sensory function, and pain. A 100-point scale is used to assess levels of interference across domains (0= not affected and 100= most affected). RESULTS Participants reported highest scores in the energy/drive (53), mobility (47), and pain (44) domains. Interactions with people (21) and community/social life (31) received the lowest scores, suggesting that domains with a strong social component were not as affected as domains with a strong physical component. Participants required significant improvement to consider their treatment successful. The mobility and energy/drive domains required significantly larger reductions than the community/social life, and interactions with people domains (P<0.006). Across all domains, participant's expectation was that the treatment would not meet their success criteria, indicating that residual levels of impairment were expected after treatment. CONCLUSIONS The results of this study point out that a number of health domains are significantly affected in this population. These patients have treatment expectations that exceed the mobility problems for which they were treated. In exploring meaningful change, the patient's expectations and success criteria must be considered.
Conference/Value in Health Info
2009-05, ISPOR 2009, Orlando, FL, USA
Value in Health, Vol. 12, No. 3 (May 2009)
Code
PMS38
Topic
Patient-Centered Research
Topic Subcategory
Adherence, Persistence, & Compliance, Patient-reported Outcomes & Quality of Life Outcomes, Stated Preference & Patient Satisfaction
Disease
Musculoskeletal Disorders, Respiratory-Related Disorders