Quality Indicators for Physiotherapy Care in Hip and Knee Osteoarthritis: Development and Clinimetric Properties

Authors

  • W. F. Peter PT,

    Corresponding author
    1. Department of Orthopaedics, Leiden University Medical Centre (LUMC), Leiden, the Netherlands
    2. Reade, Centre of Rehabilitation and Rheumatology (formerly Jan van Breemen Institute), Amsterdam, the Netherlands
    • Correspondence: W. F. H. Peter, Leiden University Medical Centre, Department of Orthopaedics, P.O. Box 9600, 2300 RC Leiden, The Netherlands. Tel: +31 71 526 2750; Fax: +31 71 526 6743.

      Email: w.f.h.peter@lumc.nl

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  • P. J. van der Wees PhD,

    1. The Royal Dutch Society of Physical Therapy (KNGF), Amersfoort, the Netherlands
    2. IQ Healthcare Nijmegen, the Netherlands
    3. CAPHRI, Maastricht University, Maastricht, the Netherlands
    4. Harvard Medical School, Boston, MA, USA
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  • E. J. M. Hendriks PhD,

    1. Centre for Evidence Based Physiotherapy, CAPHRI, Maastricht University, Maastricht, the Netherlands
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  • R. A. de Bie PhD,

    1. Centre for Evidence Based Physiotherapy, CAPHRI, Maastricht University, Maastricht, the Netherlands
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  • J. Verhoef PhD,

    1. Department of Physical Therapy, Faculty of Health, University of Applied Sciences, Leiden, the Netherlands
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  • Z. de Jong MD, PhD,

    1. Department of Rheumatology, Leiden University Medical Centre (LUMC), Leiden, the Netherlands
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  • L. van Bodegom-Vos PhD,

    1. Department of Medical Decision Making, LUMC, Leiden, the Netherlands
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  • W. K. H. A. Hilberdink MSc,

    1. Allied Health Care Center for Rheumatology and Rehabilitation, Groningen, the Netherlands
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  • T. P. M. Vliet Vlieland MD, PhD

    1. Department of Orthopaedics, Leiden University Medical Centre (LUMC), Leiden, the Netherlands
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Abstract

Objective

The aim of the present study was to develop process quality indicators for physiotherapy care based on key recommendations of the Dutch physiotherapy guideline on hip and knee osteoarthritis (OA).

Methods

Guideline recommendations were rated for their relevance by an expert panel, transformed into potential indicators and incorporated into a questionnaire, the Quality Indicators for Physiotherapy in Hip and Knee Osteoarthritis (QIP-HKOA). Adherence with each indicator was rated on a Likert scale (0 = never to 4 = always). The QIP-HKOA was administered to groups of expert (n = 51) and general (n = 134) physiotherapists (PTs) to test its discriminative power. Reliability was tested in a subgroup of 118 PTs by computing the intraclass correlation coefficient (ICC). QIP-HKOA items were included if they were considered to be related to the cornerstones of physiotherapy in hip and knee OA (exercises and education), had discriminative power and/or if they were followed by <75% of PTs in both groups.

Results

Nineteen indicators were derived from 41 recommendations. Twelve indicators were considered to be the cornerstones of physiotherapy care; six indicators had discriminative power and/or were followed by <75% PTs in both groups, resulting in an 18-item QIP- HKOA. The QIP-HKOA score was significantly higher with expert [60.73; standard deviation (SD) 5.67] than with general PTs (54.65; SD 6.17) (p < 0.001). The ICC of the QIP-HKOA among 46/118 PTs was 0.89.

Conclusion

The QIP-HKOA, based on 18 process indicators derived from a physiotherapy guideline on hip and knee OA was found to be reliable and discriminated between expert and general PTs. Its ability to measure improvement in the quality of the process of physiotherapy care needs to be further examined. Copyright © 2012 John Wiley & Sons, Ltd.

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