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Physiotherapists' views on the Australian Physiotherapy Association's Choosing Wisely recommendations: a content analysis.

ABSTRACT: OBJECTIVES:Choosing Wisely holds promise for increasing awareness of low-value care in physiotherapy. However, it is unclear how physiotherapists' view Choosing Wisely recommendations. The aim of this study was to evaluate physiotherapists' feedback on Choosing Wisely recommendations and investigate agreement with each recommendation. SETTING:The Australian Physiotherapy Association emailed a survey to all 20 029 physiotherapist members in 2015 seeking feedback on a list of Choosing Wisely recommendations. PARTICIPANTS:A total of 9764 physiotherapists opened the email invitation (49%) and 543 completed the survey (response rate 5.6%). Participants were asked about the acceptability of the wording of recommendations using a closed (Yes/No) and free-text response option (section 1). Then using a similar response format, participants were asked whether they agreed with each Choosing Wisely recommendation (sections 2-6). PRIMARY AND SECONDARY OUTCOMES:We performed a content analysis of free-text responses (primary outcome) and used descriptive statistics to report agreement and disagreement with each recommendation (secondary outcome). RESULTS:There were 872 free-text responses across the six sections. A total of 347 physiotherapists (63.9%) agreed with the 'don't' style of wording. Agreement with recommendations ranged from 52.3% (electrotherapy for back pain) to 76.6% (validated decision rules for imaging). The content analysis revealed that physiotherapists felt that blanket rules were inappropriate (range across recommendations: 13.9%-30.1% of responses), clinical experience is more valuable than evidence (11.7%-28.3%) and recommendations would benefit from further refining or better defining key terms (7.3%-22.4%). CONCLUSIONS:Although most physiotherapists agreed with both the style of wording for Choosing Wisely recommendations and with the recommendations, their feedback highlighted a number of areas of disagreement and suggestions for improvement. These findings will support the development of future recommendations and are the first step towards increasing the impact Choosing Wisely has on physiotherapy practice.

SUBMITTER: Zadro J

PROVIDER: S-EPMC6756333 | biostudies-other | 2019 Sep

REPOSITORIES: biostudies-other

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Physiotherapists' views on the Australian Physiotherapy Association's Choosing Wisely recommendations: a content analysis.

Zadro Joshua J Peek Aimie L AL Dodd Rachael H RH McCaffery Kirsten K Maher Christopher C

BMJ open 20190920 9

<h4>Objectives</h4>Choosing Wisely holds promise for increasing awareness of low-value care in physiotherapy. However, it is unclear how physiotherapists' view Choosing Wisely recommendations. The aim of this study was to evaluate physiotherapists' feedback on Choosing Wisely recommendations and investigate agreement with each recommendation.<h4>Setting</h4>The Australian Physiotherapy Association emailed a survey to all 20 029 physiotherapist members in 2015 seeking feedback on a list of Choosi ...[more]

PMID: 31542762

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Project description:BACKGROUND:It is unknown to what extent Choosing Wisely recommendations about income-generating treatments apply to members of the society generating the recommendations. The primary aim of this study is to determine the proportion of Choosing Wisely recommendations targeting income-generating treatments, and whether recommendations from professional societies on income-generating treatments are more likely to target members or non-members. The secondary aim is to determine the prevalence of qualified statements, and whether qualified statements are more likely to appear in recommendations targeting income-generating or non-income-generating treatments that apply to members. METHODS:We performed a content analysis of all Choosing Wisely recommendations, with data extracted from Choosing Wisely websites. Two researchers coded recommendations as test or treatment-based, for or against a procedure, containing qualified statements, income-generating and applying to members. Disagreements were resolved by discussion or consultation with a third researcher. A Chi-squared test evaluated whether society recommendations on income-generating treatments were more likely to target members or non-members; and whether qualified statements were more likely to appear in recommendations targeting income-generating or non-income-generating treatments that apply to members. RESULTS:We found 1293 Choosing Wisely recommendations (48.3% tests and 48.6% treatments). Ninety-eight treatment recommendations targeted income-generating treatments (17.8%), and recommendations on income-generating treatments were less likely to target members compared to non-members (15.6% vs. 40.4%, p?<?0.001). Nearly half of all recommendations were qualified (41.9%), with a similar proportion of recommendations targeting income-generating and non-income-generating treatments that apply to members containing qualified statements (49.4% vs. 42.0%, p?=?0.23). CONCLUSIONS:Many societies provide Choosing Wisely recommendations that minimise impact on their own members. Only 20% of treatment recommendations target income-generating treatments, and of these recommendations mostly target non-members. Many recommendations are also qualified. Increasing the number of recommendations from societies that are unqualified and target member clinicians responsible for de-implementation of low-value and costly treatments should be a priority.

Project description:BackgroundNo documented standard or core competencies exist for paediatric curriculum in entry-level physiotherapy programs in Australia. Consequently, extensive variability is thought to exist amongst Australian entry-level physiotherapy programs for preparing physiotherapists to work safely and effectively with children. The purpose of this study was to explore the landscape of paediatric curriculum in Australian entry-level physiotherapy programs and identify the paediatric content being covered, its perceived importance according to university academics who teach paediatrics, the mode of delivery and assessment, and the strengths, weaknesses, barriers and facilitators to implementing paediatric curriculum.MethodsA web-based desktop audit and an online cross-sectional survey using closed and open-ended questions was administered to all Australian universities offering entry-level physiotherapy programs in November 2017. Content coverage and perceived level of importance for paediatric content areas were determined using Likert scale responses. Open-ended responses were thematically analysed to identify key themes for strengths, weaknesses and facilitators to implementation of paediatric curriculum.ResultsAll (n = 20, 100%) entry-level programs used the terms lifespan, child and/or paediatrics somewhere in at least one subject descriptor. Forty-five percent (n = 9) of universities did not use the terms lifespan, child or paediatric in their published learning objectives. Eight (40%) universities offered a paediatric stand-alone course. Sixty-five (13/20) percent of universities invited, responded to the survey. For paediatric conditions the perceived level of importance was predominately higher than its course content coverage for 19 of the 31 conditions surveyed. Key barriers to implementating paediatric curriculum were: crowded curriculum, limited financial resources resulting in a lack of qualified staff, lack of prioritisation of paediatric curriculum and inadequate paediatric placement availability. Facilitators for effective implementation of paediatric content were stand-alone paediatric subjects, demonstrated dedication to paediatric curriculum and having suitably qualified faculty members.ConclusionThe results of this survey provide the physiotherapy community with the views of paediatric physiotherapy academic educators regarding the content, perceived need to expand content delivery in identified clinical areas, and the barriers and facilitators to implementing paediatric content in Australian entry-level physiotherapy programs. Further research exploring similar questions with paediatric physiotherapy clinicians would complement the findings of this study.

Project description:BackgroundBlogs are widely being used by health professionals and consumers to communicate and access nutrition information. There are numerous benefits for dietitians to establish and contribute to healthy eating blogs. In particular, to disseminate evidence-based nutrition information to promote healthier dietary practices. The aim of this study was to explore characteristics of popular healthy eating blogs and inform the provision of healthy eating information in the Australian context.MethodsA content analysis approach was used to identify characteristics of popular Australian healthy eating blogs. A purposive and snowball sampling approach was used to identify healthy eating blogs from search engines including Google, Bing and Yahoo. Blogs were deemed eligible if: (1) the author self-identified as a health professional; (2) the blog was written by a single author; (3) the blog was written by an Australian author; (4) the blog had a minimum of one post per month, and (5) the blog focused on communicating healthy eating information to the general adult population.ResultsFive popular blogs were followed over a three-month period (December 2017-March 2018), with 76 blog posts included for analysis. Characteristics of these popular blogs were examined and four main features were identified: (i) clearly conveying the purpose of each post; (ii) developing a strong understanding of the reader base and their preferences; (iii) employing a consistent writing style; use of vocabulary and layout; and (iv) communicating healthy eating information in a practical manner. These findings reveal important insight into the features that promote effective nutrition communication within this context.ConclusionFindings from this study highlight common characteristics of popular healthy eating blogs. Future research into the development of blog guidelines which incorporate the characteristics identified in this study can support dietitians in establishing or contributing to the successful provision of evidence-based nutritional information through blogs.

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Physiotherapists' views on the Australian Physiotherapy Association's Choosing Wisely recommendations: a content analysis.

Publications

Physiotherapists' views on the Australian Physiotherapy Association's Choosing Wisely recommendations: a content analysis.

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