Back to Journals » International Journal of Chronic Obstructive Pulmonary Disease » Volume 14

Development of a Standard Set of Outcome Domains and Proposed Measures for Chronic Obstructive Pulmonary Disease in Primary Care Physical Therapy Practice in the Netherlands: a Modified RAND/UCLA Appropriateness Method

Authors Verburg AC, van Dulmen SA, Kiers H, Ypinga JHL, Nijhuis-van der Sanden MWG, van der Wees PJ

Received 18 June 2019

Accepted for publication 11 November 2019

Published 28 November 2019 Volume 2019:14 Pages 2649—2661

DOI https://doi.org/10.2147/COPD.S219851

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Richard Russell


Arie C Verburg,1 Simone A van Dulmen,1 Henri Kiers,2,3 Jan HL Ypinga,4 Maria WG Nijhuis-van der Sanden,1 Philip J van der Wees1

1Radboud University Medical Center, Radboud Institute for Health Sciences, IQ Healthcare, Nijmegen, Netherlands; 2Utrecht University of Applied Sciences, Institute of Human Movement Studies, Utrecht, Netherlands; 3Association for Quality in Physical Therapy (SKF), Zwolle, Netherlands; 4CZ Healthcare Insurance, Tilburg, Netherlands

Correspondence: Arie C Verburg
Radboud University Medical Center, 114 IQ Healthcare, PO Box 9101, Nijmegen 6500 HB, Netherlands
Tel +31-243668198
Fax +31-243540166
Email koen.verburg@radboudumc.nl

Background: Standardization of measures in a common set opens the opportunity to learn from differences in treatment outcomes which can be used for improving the quality of care. Furthermore, a standard set can provide the basis for development of quality indicators and is therefore useful for quality improvement and public reporting purposes. The aim of this study was to develop a standard set of outcome domains and proposed measures for patients with COPD in Dutch primary care physical therapy practice, including a proposal to stratify patients in subgroups.
Material and methods: A consensus-driven modified RAND-UCLA appropriateness method was conducted with relevant stakeholders (patients, physical therapists, researchers, policy makers and health insurers) in Dutch primary physical therapy care in eight steps: (1) literature search, (2) first online survey, (3) patient interviews, (4) expert meeting, resulting in a concept standard set and methods to identify subgroups’ (5) consensus meeting, (6) expert meeting (7) second online survey and (8) final approval of an advisory board resulting of the approved standard set.
Results: Five outcome domains were selected for COPD: physical capacity, muscle strength, physical activity, dyspnea and quality of life. A total of 21 measures were rated and discussed. Finally, eight measures were included, of which four mandatory measures: Characteristics of practices and physical therapists, Clinical COPD Questionnaire (CCQ) for quality of life, Global Perceived Effect (GPE) for experience, 6-mins Walk Test (6-MWT) for physical capacity; two conditional measures: Hand-Held Dynamometer (HHD) (with Microfet™) for Quadriceps strength, Medical Research Council Dyspnea (MRC) for monitoring dyspnea; and two exploratory measures: Accelerometry for physical activity, and the Assessment of Burden of COPD tool (ABC). To identify subgroups, a method described in the Dutch standard of care from the Lung Alliance was included.
Conclusion: This study described the development of a standard set of outcome domains and proposed measures for patients with COPD in primary care physical therapy. Each measure was accepted for relevance and feasibility by the involved stakeholders. The set is currently used in daily practice and tested on validity and reliability in a pilot for the development of quality indicators.

Keywords: COPD, standard set, outcome domains, quality measures, PROMs, PREMs, Delphi

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]