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Associations between interim patient-reported outcome measures and functional status at discharge from rehabilitation for non-specific lumbar impairments

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Abstract

Purpose

Identify impact of frequency and timing of interim Patient-Reported Outcome Measures (PROMs) assessments during episodes of care for rehabilitation services in outpatient clinical settings on functional status (FS) outcomes at discharge for patients with low back pain.

Methods

FS outcomes of patients who had no interim PROMs were compared to outcomes of six patient groups defined by interim timing (early, mid, late) and frequency (1, 2 or more). For each comparison, patients were matched using propensity score matching for variables known to be associated with FS outcomes and for episode duration (days) and number of visits. FS was assessed using the lumbar computerized adaptive test (LCAT) where scores range from 0 to 100 with higher scores representing better physical function.

Results

A sample of 140,336 patients was considered for matching (mean age = 58 [SD = 17] range 18–89; 60% females) with 83,101 patients (59%) having no interim PROMs. Patients who had only one interim PROM, administered during early (first 2 weeks), mid (weeks 3–4), or late (week 5 or later) timing, had 4.6, 2.7, and 1.0 additional FS score points at discharge compared to those without an interim PROM, respectively (p < 0.001). Having two or more interim PROMs was associated with an additional 1.2 FS points compared to having only one interim assessment, but only if the first interim was administered early.

Conclusions

Optimal utilization of interim PROM assessment during clinical practice to enhance treatment outcomes was related to administering the first interim PROM within the first 2 weeks after the initial evaluation.

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Correspondence to Mark W. Werneke.

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Conflict of interest

Drs. Cook, Kallen, and Deutscher acknowledge that they are consultants for Focus On Therapeutic Outcomes Inc, the database management company that manages the data analyzed in the manuscript. Mr. Werneke, Dr. Hayes, and Mr. Mioduski are employees of Focus On Therapeutic Outcomes. Drs. Fritz and Woodhouse serve on the Research Advisory Board for Focus on Therapeutic Outcomes Inc. The authors certify that they have no other affiliations with or financial involvement in any organization or entity with a direct financial interest in the subject matter or materials discussed in the article.

Ethical approval

The University of Utah Institutional Review Board approved this study. As the study did not involve changes in clinical practice, data documentation, or treatment, written patient informed consent was not required.

Research involving in human and animal participants

The study did not involve human participants and/or animals.

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Werneke, M.W., Deutscher, D., Fritz, J. et al. Associations between interim patient-reported outcome measures and functional status at discharge from rehabilitation for non-specific lumbar impairments. Qual Life Res 29, 439–451 (2020). https://doi.org/10.1007/s11136-019-02314-6

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