Patient-centred care characteristics reporting in osteopathic effectiveness clinical trials : an innovative tool development and Scoping Review
Horta Moragas, Luis Miguel (2023)
Julkaisun pysyvä osoite on
https://urn.fi/URN:NBN:fi:amk-2023051711369
https://urn.fi/URN:NBN:fi:amk-2023051711369
Tiivistelmä
Introduction: Osteopathy has been defined as a patient-centred healthcare profession and for some authors, this is one of the strengths of osteopathy as a clinical approach. To date there were no evidence regarding whether the studies evaluating the effectiveness of osteopathic care followed the characteristics of patient-centred care and a scoping review was proposed to evaluate that subject. As no measurement tools to assess the presence or absence of patient-centred, person-centred, or person-focused approaches in RCTs were available in the literature, it was firstly necessary to identify the characteristic elements of those approaches.
Objectives: to visualize whether previous research evaluating the effectiveness of osteopathy was conducted considering some of the characteristics deemed to be inherent of osteopathy. As a secondary objective, to inspect whether the existing research paradigm of osteopathic research needs to be reoriented.
Methods: A literature search was conducted at Pubmed, Cinahl and Science Direct to identify RCTs evaluating effectiveness of osteopathic care published in English or Spanish between 2007 and 2022. A key term search strategy was employed using “effectiveness”, "osteopathic medicine”, “osteopathic manipulation”, “osteopathic manipulative treatment”, “osteopathy”, “osteopathic care”, “osteopathic interventions” and “Randomized Controlled Trial” to identify relevant studies. After the initial identification of 547 articles, and after the screening and eligibility processes 38 trials were finally included in this ScR.
Results: A new measurement tool including 8 main elements and 40 items has been developed to assess the level of PCC, PeCC and PFC in RCTs. Only 30% of the evaluated items were found to be present at the RCT.
Conclusions: The use of PCC, PeCC and PFC elements at osteopathic effectiveness studies is low. Including those elements may not require significant changes in future study designs but provide a better insight into what happens in real clinical practice. Future research should evaluate to what extent PCC, PeCC or PFC remains as an apparent strength of osteopathy as a clinical approach, what is the level of theoretical knowledge of osteopaths in relation to patient or person-centred approaches and what is the actual level of implementation of such approaches in daily clinical practice.
Finally, it would seem logical that the epistemological approaches evaluating osteopathic care should be coherent with the inherent characteristics of this type of approach and lead to research designs which in turn are coherent with them.
Thesis author confirms that the origin of this thesis has been checked out with Turnitin Originality Check-programme.
Objectives: to visualize whether previous research evaluating the effectiveness of osteopathy was conducted considering some of the characteristics deemed to be inherent of osteopathy. As a secondary objective, to inspect whether the existing research paradigm of osteopathic research needs to be reoriented.
Methods: A literature search was conducted at Pubmed, Cinahl and Science Direct to identify RCTs evaluating effectiveness of osteopathic care published in English or Spanish between 2007 and 2022. A key term search strategy was employed using “effectiveness”, "osteopathic medicine”, “osteopathic manipulation”, “osteopathic manipulative treatment”, “osteopathy”, “osteopathic care”, “osteopathic interventions” and “Randomized Controlled Trial” to identify relevant studies. After the initial identification of 547 articles, and after the screening and eligibility processes 38 trials were finally included in this ScR.
Results: A new measurement tool including 8 main elements and 40 items has been developed to assess the level of PCC, PeCC and PFC in RCTs. Only 30% of the evaluated items were found to be present at the RCT.
Conclusions: The use of PCC, PeCC and PFC elements at osteopathic effectiveness studies is low. Including those elements may not require significant changes in future study designs but provide a better insight into what happens in real clinical practice. Future research should evaluate to what extent PCC, PeCC or PFC remains as an apparent strength of osteopathy as a clinical approach, what is the level of theoretical knowledge of osteopaths in relation to patient or person-centred approaches and what is the actual level of implementation of such approaches in daily clinical practice.
Finally, it would seem logical that the epistemological approaches evaluating osteopathic care should be coherent with the inherent characteristics of this type of approach and lead to research designs which in turn are coherent with them.
Thesis author confirms that the origin of this thesis has been checked out with Turnitin Originality Check-programme.