A cohort investigation of patient-reported function and satisfaction after the implementation of advanced practice occupational therapy–led care for patients with chronic hand conditions at eight Australian public hospitals

Abstract

Study DesignProspective cohort. IntroductionPatients referred to medical specialist outpatient clinics in Australian public hospitals often wait longer than the recommended timeframe for their first appointment. This study examines the use of advanced hand therapy practitioners to facilitate access to care for long-waitlisted patients with chronic hand conditions. Purpose of StudyTo examine patient-reported function and satisfaction outcomes with advanced practice hand therapy. MethodsData was collected from eight public hospital outpatient departments in Queensland, Australia. Patients with chronic hand conditions were screened from waitlists at each site and invited to participate in the hand therapy program while waiting to see a medical practitioner. ResultsA total of 1947 patients were screened from the waitlists, and 1116 patients completed advanced practice therapy. Patients completing hand therapy were older (P ≤ .001) and more likely to have more than one diagnosis (P ≤ .001). They reported a significant improvement in function using the Michigan Hand Questionnaire (P ≤ .001) and demonstrated increased grip strength (left injuries P = .016, right injuries P = .001). Ninety-three percent were satisfied or highly satisfied with hand therapy care. Some variation in Michigan Hand Questionnaire scores was observed across different diagnoses, with those with carpal tunnel syndrome and trigger finger reporting the best outcomes. ConclusionsAdvanced practice hand therapy for long-waitlisted patients with chronic hand conditions was associated with improvements in patient function and satisfaction. Further research is warranted to study the specific response of different diagnostic groups to intervention using this model of care.