Patient Satisfaction With Private Physiotherapy for Musculoskeletal Pain

[Usteo]

http://www.medscape.com/viewarticle/574950?src=mp&spon=34&uac=102588BX

Abstract

Background: Despite emphasis on patient centred healthcare, healthcare professionals have been slow to use validated measurements of patient satisfaction in physiotherapy practice. The aim of this cross sectional survey was to measure patient satisfaction with private physiotherapy in Ireland, for patients with musculoskeletal pain, using a previously validated survey instrument.
Methods: A multidimensional patient satisfaction questionnaire 'PTOPS', which assesses patient satisfaction with outpatient physiotherapy treatment, was translated from American English to European English, and relevant demographic and global satisfaction items were included. This was then circulated to patients with musculoskeletal pain (n = 240) for anonymous completion and return to the research team. Data were analysed using the Statistical Package for the Social Sciences (SPSS, v.12).
Results: In total 55% (n = 131/240) of questionnaires were returned. Just over half of the respondents were male (53.4%, n = 70), with a mean age (SD) of 37.7 years (12.4), and had previous experience of physiotherapy (65.6%, n = 86). The most common site of musculoskeletal pain was spinal (51.5% n = 66). The mean (SD) number of treatments was 8.3 (8.3), at a mean total cost (SD) of €350.2 ( €322.8 ). The 'PTOPS' questionnaire categorised and scored satisfaction items under four domains, Enhancer, Detractor, Location and Cost. The mean score (SD), optimum score, and scoring range for each domain were: 'Enhancer' 41.2 ( 3.8 ), 50, 10-50; 'Detractor' 19.4 (4.4), 10, 10-50; 'Location' 28.0 ( 4.1 ), 35, 7-35; 'Cost' 18.9 ( 2.8 ), 7, 7-35. "Overall satisfaction with physiotherapy experience" was scored on a five-point scale "excellent to poor", with a modal response of "Very Good" (42%; n = 55).
Conclusion: This study measured patient satisfaction with private physiotherapy treatment for musculoskeletal pain in Ireland using a previously validated outcome measure and provides a template for future studies of this increasingly important topic. Results demonstrated high levels of satisfaction with all components of physiotherapy treatment, except cost, and provided valuable patient feedback regarding their physiotherapy treatment for musculoskeletal pain. Results can be used by physiotherapists to improve future patient experiences with a view to improving patient attendance and compliance with physiotherapy treatment protocols for patients with musculoskeletal pain.

Anyone know of any similar patient satisfaction studies conducted for osteopaths?

[Osteotate]

Proper PDF version of this article is available at:
http://www.biomedcentral.com/1471-2474/9/50

** Mean number of treatments for Physio = 8.3

If you remember that the AOA got stats from one or two health funds a year or two ago that showed how many visits their members had per year with Chiro/Osteo combined which equaled about 12 and Osteo alone was about 3-4.  The problem with these stats is that once a patient reaches their limit of how many treatments they can claim, they will not claim any more so I suspect the true number for Chiro/Osteo combined would be higher.

[Luke Rickards]

Voila!

Patient satisfaction with osteopathic treatment
Leach J1, Strutt R2, Shaw Q2, Focus Alternat Complement Ther 2005

Objective
To conduct a qualitative study to gain understanding of patients’ perceptions of care, outcomes and quality of osteopathic treatment.
Materials and methods
A questionnaire survey was sent to all patients attending the undergraduate training clinic (1998–2000) at the John Wernham College of Classical Osteopathy. A content analysis of the free text responses was carried out to identify codes and themes.
Results
Two hundred and ninety-two questionnaires were sent out and 181 (65%) were returned. Personal recommendation was the most common reason for selecting this clinic. Over 80% presented with musculo-skeletal complaints. 91% of subjects were satisfied or highly satisfied with treatment. The respondents attached value to professional thoroughness and dedication, empathy and positive supervision of students. Patients placed a very high value on explanations in terms that fitted their body experience and personal beliefs. Strong feelings were also voiced around privacy and undressing. This may be a barrier to attending. Seventy-nine per cent of respondents perceived that their health had improved as a result of treatment. Other health outcomes mentioned included knowing that pain relief was possible and empowerment through self help. As one patient said ‘The treatment has given me hope and has helped enormously.’
Conclusion
This qualitative survey yielded rich insights not possible with a structured questionnaire. The results suggest osteopathic trials should use wider outcome indicators than disability and pain scales. The recently formed National Council for Osteopathic Research will develop research priorities towards building the osteopathic evidence base.

Patient satisfaction and clinical outcomes associated with osteopathic manipulative treatment
J Licciardone; R Gamber; K Cardarelli, JAOA • Vol 102 • No 1 • January 2002 • 13-20

A patient survey was used to measure and explain patient satisfaction and clinical outcomes associated with osteopathic manipulative treatment (OMT). Participating in the survey were 459 people who attended an ambulatory OMT specialty clinic from March 1998 through September 1998 and who had received OMT there at least twice previously. Standardized patient satisfaction scores were greatest for overall performance (0.61 +/- 0.29) and interpersonal manner (0.61 +/- 0.24). Satisfaction with finances (0.11 +/- 0.31) was significantly lower than for all other global dimensions of care (P < .001). Subjects perceived OMT to be highly efficacious (0.74 +/- 0.34) and reported significant relief from pain or discomfort (P < .001) and improvement in mobility (P < .001). Of all the respondents, 8.6% attributed an adverse reaction to OMT. Perception of OMT efficacy was significantly associated with all dimensions of patient satisfaction (P values ranged from less than .001 to .003). Relief from pain or discomfort was significantly associated with overall satisfaction (P < .001). Females had greater reduction in pain or discomfort than males (P = .001). Respondents perceived significant community shortages of OMT services through primary care (-0.45 +/- 0.50; P < .001) and specialty (-0.35 +/- 0.54; P < .001) physicians, and reported significant dissatisfaction with insurance coverage for OMT services (-0.09 +/- 0.57; P = .001). These findings suggest the need for greater access to OMT services.

Should your GP be an osteopath? Patients' views of an osteopathy clinic based in primary care.
Westmoreland JL, Williams NH, Wilkinson C, Wood F, Westmoreland A. Complement Ther Med. 2007 Jun;15(2):121-7.

BACKGROUND: Spinal pain is a common reason for consulting general practitioners (GPs), and complementary therapists such as osteopaths and chiropractors. Patients express greater satisfaction with the care from chiropractors and osteopaths, because they are perceived as having more empathy, diagnostic skill and effective treatment, but their attitude to a GP providing an osteopathy service is unknown.
AIM: To explore patients' views of receiving osteopathy in contrast with usual GP care, to provide insight into the psychological benefit of treatment, and to explore their views on how such a service should be provided and funded.
DESIGN OF STUDY: Qualitative study using semi-structured interviews preceded by short questionnaires.
SETTING: Primary care osteopathy clinic treating patients from Llanfairfechan Health Centre, which also accepted referrals from neighbouring practices in North West Wales in a randomised controlled trial.
METHOD: Short questionnaires followed by semi-structured interviews with 20 participants. The interview transcripts were analysed by open coding into categories, axial coding to define the categories' properties and selective coding for the final thematic account.
RESULTS: Traditional GP skills were valued, but GP care for spinal pain was perceived as limited and ineffective. Osteopathy was attractive because it did not involve drugs, but it had short-term painful side effects, and some found it frightening. Physical benefits included increased mobility and reduced pain; psychological benefits included removal of fear and improved understanding. Provision of osteopathy by a GP was welcomed, so long as the GP was properly qualified, and had sufficient time.
CONCLUSION: A GP run osteopathy clinic provided additional physical and psychological benefit. GP consultation might be improved by adopting some features from the osteopathic consultation.

Patients' satisfaction with osteopathic and GP management of low back pain in the same surgery.
Pincus T, Vogel S, Savage R, Newman S. Complement Ther Med. 2000 Sep;8(3):180-6.

Chronic low back patients reported their satisfaction with the treatment they received for back pain from GPs and osteopaths practising in the same surgery. Although levels of satisfaction were high for all treatments, patients reported significantly higher scores for satisfaction with the osteopathic treatment. The difference was stronger for aspects of care/communication and competence, and weaker for satisfaction with efficacy. These findings are discussed in reference to patients' expectations, novelty, time spent with patients, number of visits, and patients' age.

[David S]

Hi luke

I have always felt that "satisfaction' type studies seem a bit dodgy. Although, I have to admit that I have never realy read one through properly.

I reckon I am going to do one of these studies doing comparing Osteo and Physio. I will select a bunch of "Hot" looking Osteos. with good personalities and select the ugliest Physios I can find with Terrets type of personalities and I reckon the results will get us into Hospitals.

PM me if you think you want to be in the study (include photo)

[Luke Rickards]

David,

That's too funny.   

I'm sure there's an element of truth there though. Looking at the Pincus et al. abstract, directly comparing GP to osteo, it seems that being nice was more important to patients than being efficacious.

I think having insight into patient satisfaction can be useful though, since it is so closely tied to patient expectations - and expectation has also proven key to placebo mechanisms. Unless, of course, one considers placebo responses absent or undesirable in their practice.

Regarding your study - Just a head shot, or shall I take one in my speedos?

[David S]

^^^^^^ U-Tube video in speedos will do. As you know, movement is very important in our field!