Enhancing physiotherapists' knowledge and skills in facilitating self-management of patients with chronic musculoskeletal pain conditions: a best practice implementation project.

Abstract

Introduction: Evidence-based self-management strategies in chronic disease management are associated with increased self-efficacy and improved health-related quality of life. Physiotherapists feel unprepared to promote these strategies in patients with chronic musculoskeletal pain conditions.

Objective: The objective of this best practice implementation project was to assess and promote exercise-centered self-management strategies in physiotherapy care.

Methods: JBI's Evidence Implementation Framework, Practical Application of Clinical Evidence System (PACES) audit tool, and Getting Research into Practice (GRiP) method were used. The project was conducted in Germany at the University Hospital of the Brandenburg Medical School in the Department of Physiotherapy. Barriers and facilitators to implementation were identified through qualitative interviews with musculoskeletal pain experts in the team (N  =  5). All team members (N  =  16) completed a 31-item standardized questionnaire to determine compliance with seven audit criteria. The results of the baseline audit informed the implementation strategy. A post-implementation audit was conducted to measure improvements in practice.

Results: Baseline compliance with audit criteria ranged from 0% to 89%. Barriers to implementation included lack of knowledge on self-management facilitation (e.g., assessment of patient capabilities, pain education, goal-setting, self-monitoring, action plan development) and no standardized documentation. The implementation strategy combined interactive educational training with the introduction of two standardized assessment and documentation forms. Moreover, a short-form exercise diary was created to facilitate patient self-monitoring. In the follow-up audit, five of the seven audit criteria improved.

Conclusions: A combination of interactive educational training, standardized physiotherapy assessment and documentation, and a short-form exercise diary may be appropriate strategies to increase compliance for exercise-related self-management facilitation.

Spanish abstract: http://links.lww.com/IJEBH/A345.