Article
Development and feasibility of a multi-disciplinary care pathway in primary care to improve mobility and participation of older patients with vertigo, dizziness and balance disorders [MobilE-PHY]
Search Medline for
Authors
-
Eva Seckler
- Rosenheim Technical University of Applied Sciences, Department of Research and Development, Rosenheim, Deutschland; Münchner Netzwerk für Versorgungsforschung, MobilE-NET, Deutschland
-
Verena Kronast
- Rosenheim Technical University of Applied Sciences, Department of Research and Development, Rosenheim, Deutschland; Münchner Netzwerk für Versorgungsforschung, MobilE-NET, Deutschland
-
Petra Bauer
- Rosenheim Technical University of Applied Sciences, Department of Research and Development, Rosenheim, Deutschland; Rosenheim Technical University of Applied Sciences, Faculty of Applied Health and Social Sciences, Rosenheim, Deutschland; Münchner Netzwerk für Versorgungsforschung, MobilE-NET, Deutschland
-
Martin Müller
- Rosenheim Technical University of Applied Sciences, Department of Research and Development, Rosenheim, Deutschland; Rosenheim Technical University of Applied Sciences, Faculty of Applied Health and Social Sciences, Rosenheim, Deutschland; Münchner Netzwerk für Versorgungsforschung, MobilE-NET, Deutschland
| Published: | September 11, 2019 |
|---|
Outline
Text
Background: Many older people suffer from vertigo, dizziness and balance disorders (VDB), which may lead to mobility limitations and participation restrictions. Those patients may benefit from physical therapy, however the integration into routine primary care is scarce. A promising approach to optimize treatment, to reduce treatment errors and to optimize patient outcomes by translating evidence into local practice are care pathways (CPWs).
Objective: The objective of the project was to develop a CPW to improve participation and mobility in older patients in primary care and to assess acceptability and feasibility in a pilot study.
Methods: To develop the specific CPW, we combined input from two systematic reviews (effectiveness of physical therapy interventions; conditions of CPW implementation in primary care); individual qualitative interviews to explore the professionals and consumers’ perspective; focus group interviews among professionals addressing multi-professional communication; and a multi-disciplinary expert conference.
In a prospective cohort study, feasibility of the CPW will be assessed, accompanied by a comprehensive process evaluation; the intervention will be implemented in 3-4 primary care practices with each 5-10 patients. The main CPW-components are a diagnostic guideline and an educational training for general practitioners, a guideline and an educational training for local physical therapists and a paper-based algorithm. Data will be collected using questionnaires (DHI, EQ-5D-5L), performance test (miniBEST) and actigraphy.
Results: We expect the project to result in an acceptable and feasible intervention. The feasibility study starts in spring 2019; preliminary results will be available at the conference.
Discussion: The results will be used to plan the main trial assessing the CPWs effectiveness and safety. The intervention might be a blueprint for CPWs for other health conditions.
Take home message for practical use: CPW-development and -implementation has to address a multitude of barriers by including different perspectives; most of them might be modified by careful intervention and implementation design.
