Development of a Checklist to Assist Physiotherapists in Determination of Patients' Suitability for a Blended Treatment

TLDR

Blended care, which integrates digital applications into health care, is increasingly adopted but physiotherapists struggle to identify patients suitable for such treatment. This study aimed to create a checklist that helps physiotherapists determine patient suitability for blended physiotherapy and to identify characteristics influencing the balance between therapist guidance and digital application use. A scoping review of PubMed and PEDro up to December 2017 identified themes of patient suitability, from which the authors drafted an initial Dutch Blended Physiotherapy Checklist and refined it through expert feedback. The final checklist comprises eight items—motivation, safety, equipment, digital skills, health literacy, self‑management, time, and financial factors—to guide physiotherapists in tailoring blended physiotherapy.

Abstract

Background:The integration of digital applications within health care is called blended care. Introduction:Despite its potential, physiotherapists experience difficulty in determining which patients are suitable for blended care. This study aimed to develop a checklist to support physiotherapists while setting up a blended treatment. Therefore, we aimed to investigate which patient characteristics predict patients' suitability for blended physiotherapy and which patient characteristics need to be taken into account while determining the ratio between therapeutic guidance and a digital application. Methods:A scoping review was conducted consisting of (1) literature search in PubMed and PEDro up to December 2017: studies were eligible if they focused on blended physiotherapy consisting of contact at least twice with a physiotherapist complemented by a digital application, and characteristics related to patients' suitability for blended physiotherapy were extracted and categorized in themes; (2) a checklist item for each theme formulated by the authors, which resulted in a first version of the Dutch Blended Physiotherapy Checklist; and (3) expert opinion and feedback on clinical relevance by six experts. The checklist was adapted accordingly. Results:The final Dutch Blended Physiotherapy Checklist consists of eight items: motivation, safety, equipment, digital skills, health literacy, self-management, time, and financial factors. Discussion:The next step is to investigate the feasibility and predictive validity of the checklist, that is, whether this checklist is actually able to predict patients' suitability for blended physiotherapy. Conclusions:This study provides the final version of the Dutch Blended Physiotherapy Checklist, which is supposed to guide physiotherapists in their clinical reasoning process while setting up a personalized, blended physiotherapy treatment.