Occupational Therapy In Primary Care Research Articles

Evaluation of occupational therapy in persons with COVID-19: a pre-post observational cohort study.

Persons with COVID-19 may experience limitations in daily functioning and can be referred to occupational therapy. To evaluate changes in daily functioning, cognitive complaints, fatigue and self-management of persons with COVID-19 who received occupational therapy in primary care.To get insights in the volume and duration of occupational therapy. A pre-post observational cohort study from October 2020 until April 2021. Fifty-eight occupational therapy practices in primary care throughout the Netherlands participated with 68 occupational therapists. 228 adults (≥18 years) with COVID-19, referred to occupational therapy, gave informed consent and participated in the pre-post evaluation. The mean age was 49 years (SD 13) and 79% of the patients was female. The most frequently reported complaints included fatigue and cognitive complaints. Occupational therapy using Dutch guidelines for occupational therapy in clients with COVID-19. Performance and satisfaction with performance using the Canadian Occupational Performance Measure (COPM); the impact of Cognitive Complaints on Participation (CoCo-P); and daily activities, self-management and perceived contribution of occupational therapy using the Patient Reported Outcome Measure for Occupational Therapy (PROM-OT). COPM-performance score improved with a mean difference of 2.9 points (95% CI 2.7 to 3.2), and COPM-satisfaction score improved with 3.2 points (95% CI 2.9 to 3.5). CoCo-P score improved with a mean difference of 20.9 points (95% CI from 14.4 to 27.4), and PROM-OT improved with 42.8 points (95% CI from 40.2 to 45.4). Participants received a median of seven sessions of occupational therapy (IQR 5-10) with a median duration of 18 weeks (IQR 12-25). They valued the contribution of occupational therapy to their improved functioning with a mean score of 8 (SD 1.4) and recommended this to others with a mean score of 9 (SD 1.2). Persons with COVID-19 who received occupational therapy in primary care improved significantly in daily functioning and highly valued occupational therapy.

Wrist Stabilising Exercise Versus Hand Orthotic Intervention for Persons with Hypermobility - A Randomised Clinical Trial.

To investigate the effectiveness of wrist stabilisation exercises compared to conventional intervention, whether it reduces pain and/or paraesthesia in the hand, as well as how the interventions affected activity ability, health-related quality of life and effects on hand function and grip strength in people with Hypermobility Diagnosis. A randomised controlled trial.Setting: Units of Occupational therapy in Primary Care, Kalmar County Council, SwedenParticipants: The study included 169 participants' data randomised to the Exercise group (n = 83) or the Control group (n = 86). The samples consisted of adults in diagnosed Hypermobility Spectrum Disorders or hypermobility Ehlers Danlos Syndrome with symptoms of pain and/or paraesthesia in the hands in the last three years.Interventions: The Exercise group trained according to structured progressive exercises and weights programme. The Control group used the hand orthosis during selected activities. Both groups performed randomised intervention for 12 weeks.Main measures: The primary outcome was the Disabilities of Arm, Shoulder, and Hand questionnaire. Secondary outcomes were the Grip Ability Test, the Jamar dynamometer and the EuroQol EQ-5D. There were 116 subjects who completed the intervention. There were no statistically significant difference between the wrist stabilisation exercise and the conventional intervention in terms of activity ability, health-related quality of life, hand function, grip strength, pain or paraesthesia in people with Hypermobility Spectrum Disorders or hypermobility Ehlers Danlos Syndrome. There is no statistically significant difference between the Exercise group and the Control group regarding activity ability after 12 weeks intervention period.

Primary Care Occupational Therapy: Diagnoses, Outcomes, Reimbursement, and Team Satisfaction

Primary Care Occupational Therapy: Diagnoses, Outcomes, Reimbursement, and Team Satisfaction

Research priority 5: Setting the stage for research on the impact of occupational therapy in primary care

Research priority 5: Setting the stage for research on the impact of occupational therapy in primary care

Role of Occupational Therapy in Pediatric Primary Care: Promoting Childhood Development.

Occupational therapy practitioners have the opportunity to promote development for all children as new service delivery models are established for pediatric primary care. Three action steps are identified: (1) advocacy for legislation that requires developmental screenings and surveillance, (2) support of culturally responsive developmental monitoring, and (3) building evidence for occupational therapy in primary care settings. This article describes the role of occupational therapy practitioners on pediatric interprofessional teams in encouraging family capacity within the scope of health promotion and universal developmental monitoring.

Occupational Therapy in Primary Care -- Barriers, Pivots, and Outcomes: A pilot study

Purpose: Habits, roles, and routines are important behaviors that affect lifestyle and can lead to the development of chronic disease such as diabetes mellitus. Primary care physicians (PCPs) have limited time, suggesting an interprofessional team approach would be beneficial in helping patients modify behaviors for the prevention and treatment of chronic disease. Occupational therapists (OTs) specialize in addressing health behaviors, and literature supports including OTs on the primary care team to improve the self-management techniques of patients with chronic disease. This study was guided by Lifestyle Redesign®, an evidence-based program that addresses the health behaviors of patients with diabetes in primary care. We aimed to improve health outcomes by combining an OT-led lifestyle modification program with patient-centered treatment recommendations from an external interprofessional team. We hypothesized that the health outcomes of patients with diabetes in primary care would improve after participating in an OT-led interprofessional lifestyle modification program, and that reimbursement for services would be obtainable. Method: Two PCPs in community practice initially agreed to involve an OT on their primary care team. Due to reimbursement concerns, the PCPs later preferred to refer patients to receive the OT-led intervention at an offsite clinic, rather than onsite at the primary care practice. Health outcomes were measured pre- and post-intervention using industry standard assessments and biometrics. Descriptive and non-parametric statistics were used to evaluate change. Results: Thirty-one patients with diabetes were referred, and three (9.7%) participated in the offsite lifestyle modification program. While statistical significance was not achieved (p≥0.10), trends toward individual improvement were noted for occupational performance and satisfaction and empowerment, and reimbursement was received from the third-party payers. Conclusions: Patient participation in this study was consistent with participation rates for offsite behavioral health referrals. An offsite OT-led interprofessional lifestyle modification program demonstrated potential for meaningful change and services were reimbursed. These findings support practice redesign efforts to include OTs as part of an integrated primary care model. Offering onsite services will increase patient accessibility to care and improve referral completion rates, thus providing OTs the opportunity to further demonstrate the efficacy of delivering chronic disease management in primary care.

Role of Occupational Therapy in Primary Care.

The American Occupational Therapy Association (AOTA) affirms that occupational therapy practitioners1 are well prepared to contribute to interprofessional collaborative care teams addressing the primary care needs of individuals across the life course. Because of an increased focus on preventive population health and social determinants of health by health care organizations, synergy between primary care and occupational therapy is growing, with support for client-centered,2 comprehensive whole-person care, health promotion and prevention, disease self-management, and quality of life (Halle et al., 2018). Occupational therapy practitioners' distinct knowledge of the significant impact that roles, habits, and routines have on health and wellness makes their contribution to primary care valuable (AOTA, 2020b). Occupational therapy's focus on meaningful engagement in occupations is relevant and vital to participation in individual, family, and community life (AOTA, 2020c). In addition, occupational therapy practitioners' holistic and population perspectives allow them to be effective both as interprofessional health care team members and as direct care providers to support client, family, and community needs in primary care delivery models (Leland et al., 2017). The purposes of this position paper are to define primary care and to describe occupational therapy's evolving and advancing role in primary care, including expansion of services into specialty primary care areas such as pediatric primary care and obstetrics and gynecology (AOTA, 2018).

Developing Tailored Program Proposals for Occupational Therapy in Primary Care

Developing Tailored Program Proposals for Occupational Therapy in Primary Care

Occupational therapy in primary care: exploring the role of occupational therapy from a primary care perspective.

General practice faces a workforce crisis, constrained finances, unsustainable workloads, and increasingly complex medical and care needs.1,2 The Royal College of General Practitioners (RCGP) highlighted the challenge in 2015, stating that the number of consultations per year in England had increased by more than 60 million.3 The Five Year Forward View supports focusing on prevention and managing patients within the community.2 The General Practice Forward View identifies the need to build the wider workforce in primary care to address some of these challenges.4 The RCGP has supported work promoting and developing innovative roles to alleviate pressures that the system is facing.3 Occupational therapists are highly skilled practitioners working across health and social care. A clear fit with primary care regarding health promotion and holistic care has already been recognised.5 Occupational therapists value the importance of promoting mental and physical wellbeing, and are skilled in assessing the impact of developmental, physical, and mental health conditions.6 Occupational therapists are not routinely utilised within the primary care workforce in England despite their potential to provide valuable skills, support, and resource to GPs. An article in the BJGP by Brooks and Milligan7 supports the integration of occupational therapy (OT) in the delivery of Sustainability and Transformation Plans. They argue that this offers a cost-effective solution that ‘... reduces pressure on GPs, reduces referral to secondary care, enhances timely hospital discharge, and keeps people independent at home.’ . The University of Southampton OT Programme has developed student placements in diverse, non-traditional areas of practice. The concept driving these placements is the establishment of an OT role in new areas to demonstrate the added value that an …

Occupational Therapy in Primary Care: Positioned and Prepared to Be a Vital Part of the Team.

Reilly's (1962) now deeply cherished statement that "man, through the use of his hands, as they are energized by mind and will, can influence the state of his own health" (p. 1) was followed a few years later with a question to current and future occupational therapy practitioners. In 1966, Reilly asked how the profession would respond to the challenges of an expanding knowledge base, accelerating health care costs, and escalating regulatory burden. Visionary Wilma West, a contemporary of Reilly's, expanded on these themes by focusing on ways occupational therapy practitioners could leverage the breadth and depth of their practice to confront these challenges. These issues are now paramount in the primary care arena. An expanding body of literature, including the articles in a special section in this issue of the American Journal of Occupational Therapy, supports occupational therapy's role as a vital part of the solution to contemporary health care challenges. Occupational therapy practitioners are educationally prepared and successfully poised through policy to engage in evidence-based practice in the primary care environment.

Primary Care Occupational Therapy: How Can We Get There? Remaining Challenges in Patient-Centered Medical Homes.

Passage of the Patient Protection and Affordable Care Act in 2010 mandated reform of the United States' existing primary care system. As part of this reform, advanced practice models, including the Patient-Centered Medical Home model, expanded, with the goal of increasing the use of interprofessional teams. Integrating occupational therapy was promoted as an opportunity to enhance the value of care provided in these redesigned primary care practices. However, occupational therapy's presence in primary care is still extremely limited.

Retrospective Analysis: Most Common Diagnoses Seen in a Primary Care Clinic and Corresponding Occupational Therapy Interventions

Background: The literature supports occupational therapy (OT) on primary care (PC) interprofessional teams; however, due to uncertainty regarding the role of, and reimbursement for, OT in PC, few occupational therapists practice in PC. This study addressed the first barrier by identifying the 15 most common diagnoses in a specific PC practice and determining how many of them have evidence-based OT interventions appropriate for their treatments.

Evidence-Based Practice in Primary Care Occupational Therapy: A Cross-Sectional Survey in Sweden.

Introduction Understanding of attitudes, knowledge, and behaviour related to evidence-based practice (EBP) and guidelines in Swedish occupational therapy is limited. The study aims were to investigate attitudes, knowledge, and behaviour related to evidence-based practice and guidelines of Swedish occupational therapists in primary care. Methods A web-based survey of 94 Swedish primary care occupational therapists (response rate 53.7%). Data were analysed using logistic regressions. Results Attitudes towards EBP and guidelines were highly positive (97%–98%). About half of the respondents reported confidence in finding and using evidence. Almost two-thirds reported being aware of guidelines and 47% knowing where to find guidelines. Four-fifths stated that they had easy access to guidelines and 75% that they used guidelines frequently. Men were more likely to feel confident to find research (OR 8.58, 95% CI 1.03 to 71.66; p = 0.047) and have easy access to guidelines (OR 9.10, 95% CI 1.94 to 42.83; p = 0.005). Occupational therapists older than 50 years were more likely to integrate patient preferences with guideline use (OR 6.44, 95% CI 1.14 to 36.57; p = 0.035). Few reported reading scientific articles, and many expressed uncertainty in finding research. The main barrier for using guidelines was reported to be lack of time. Conclusion Although attitudes among primary care occupational therapists towards EBP are positive and a large proportion report using guidelines, many state that they want to learn more and improve their evidence-based practice skills. The findings suggest that education measures need to be taken to address the identified shortcomings.

Occupational Therapy in Primary Care: Structures and Processes that Support Integration

Few studies have outlined the processes and structures needed to develop and integrate occupational therapy into a primary care provider’s office setting. This paper focuses on implementation of the clinic model of occupational therapy in primary care and is intended to address the deficiencies in current literature, including detailed program development steps. Barriers identified in the 8-week pilot program and the successful development of a reimbursable occupational therapy service in primary care will be discussed. The results of the implementation of occupational therapy in primary care are positive. The providers have accepted and embraced the distinct value of occupational therapy in this setting. Occupational therapy in the primary care setting is an emerging area of practice and further research is needed to measure the impact of interventions in this setting and the relationship to outcomes.

Occupational Therapy in Primary Care: Determining Receptiveness of Occupational Therapists and Primary Care Physicians to Occupational Therapy in Primary Care

Abstract Date Presented 3/30/2017 Barriers to inclusion of occupational therapy in primary care are noted. Occupational therapists (OTs) and primary care physicians (PCPs) were surveyed to determine receptiveness of OTs and PCPs to occupational therapy in this setting when barriers were addressed. Results suggest that OTs and PCPs are receptive to occupational therapy in this setting if barriers are addressed. Primary Author and Speaker: Sue Dahl-Popolizio Additional Authors and Speakers: Kaila Davis, Rachael Voysey, Sabby Wade, Sherry Muir

Occupational Therapy in Primary Care: Determining Receptiveness of Occupational Therapists and Primary Care Providers

Background: Primary care (PC) is an emerging practice setting for occupational therapy; however, few occupational therapists currently practice in this setting due to barriers, including uncertainty about reimbursement and the role of occupational therapists. This pilot study aimed to determine if PC providers and occupational therapists are receptive to occupational therapists as integrated interprofessional PC team members if barriers to inclusion are addressed.

Occupational therapy in primary care: Results from a national survey: L'ergothérapie dans les soins primaires : Résultats d'un sondage national.

To support integration of occupational therapy in primary care and research in this area, it is critical to document examples of occupational therapy in primary care. This study describes occupational therapy roles and models of practice used in primary care. An electronic survey was sent to occupational therapists across Canada. Participants were identified using purposive and snowball sampling strategies. Descriptive statistics were used to analyze the data. Respondents ( n = 52) were almost exclusively working on interprofessional teams. Intervention was provided most frequently to individual clients, and services were provided both within the home/community and in the clinic. Occupational therapists offered a range of health promotion and prevention services, predominantly to adults and older adults. A number of supports and barriers to the integration of occupational therapy were identified. A growing number of occupational therapists are working in primary care providing a broad range of services across the life span.

Primary Care: A New Context for the Scholarship of Practice Model

ABSTRACT Interest in the emerging role for occupational therapy in the primary care practice setting has increased due to implementation of the Patient Protection and Affordable Care Act (ACA), which intends to expand health care coverage to uninsured Americans while improving coordination of care, health outcomes, and cost savings. Expanding occupational therapy to encompass promotion of wellness and prevention in a primary care context provides an opportunity for occupational therapy. The purpose of this article is to describe the role of occupational therapy in primary care and how the Scholarship of Practice model can guide the development of occupation-based and evidence-based best practice in primary care.

The role of occupational therapy in primary care.

The role of occupational therapy in primary care.

The emerging role of occupational therapy in primary care.

Few studies have examined the role of occupational therapy working in a primary care setting. The objective of the study was to describe the emerging role of occupational therapy in Family Health Teams, a model of interprofessional primary care. A multiple case study design was used to provide in-depth description of the occupational therapy role. Data collection included interviews, document analyses, and questionnaires. Each case was first analyzed individually, followed by cross-case analyses to determine common themes. The role of occupational therapy in Family Health Teams epitomizes that of a generalist, whose overarching focus is on function. Occupational therapists are working across the life span with a wide range of client populations. Older adults and individuals with complex chronic conditions are two prominent areas of occupational therapy focus. Understanding the impact of health conditions on daily function and enabling participation in activities are unique and important contributions of occupational therapy.