Background The use of discharge reports (DR) as communication are mandatory in health care in most countries. Interprofesional collaboration is based on shared information and the DR is a minimum base for information sharing in most health care systems. To ensure treatment quality and patient safety, the information shared in DR must be precise and all terms used must be well understood by all professions in need of information regarding treatment modalities and treatment outcome.
Several studies have revealed that OA treatment is not in line with evidence based guidelines (1,2,3). This study assesses how physiotherapists are communicating their treatment of OA patients in the outpatient clinics to referring physician.
Objectives To assesses how physiotherapists are communicating their treatment of OA patients in the outpatient clinics to referring physician.
Methods Patient records in the hospital region of middle Norway were searched to identify patients with knee OA. A letter was sent to the identified patients (N=83) asking for information about which physiotherapist they had seen for treatment. A letter was then sent to the physiotherapists asking for the discharge report, which they are obliged to send to the referring physician. A survey of the content in the discharge reports was conducted by three independent well qualified health professionals.
Results Response rate from patients was 93 percent (N=81). Of the 81, 13 (15 percent) had not been referred to physiotherapy treatment. Response rate from physiotherapists (N=68) was 39 (56 percent).
The information given in the DR's was incomplete and the language was imprecise regarding OA treatment. None of the DR met the criteria for what is supposed to be in a DR. In 11% of the DR's it was not possible to rule out what kind of treatment was provided to the patient. Descriptions used was “easy strength training”, “hip and knee group”, and “deep massage, hip and lumbal training”; these are all examples of complete information on knee OA treatment extracted from the DR's.
Conclusions This study indicates that the physiotherapists do not list the information needed by other health care professions regarding OA treatment. There seem to be a need to stress the importance of describing exercise as if it was medication, in terms of what kind of medication (type of exercise), the dose (how intense), ratio (how often). If a patient is to be followed up of another health care provider (MD, PH or other) imprecise description,- or lack of description of treatment provided may be harmful for the patient. It may also make it difficult to compare different treatment regimes if the information in the DR's are incomplete or missing
Østerås N, Jordan KP, Clausen B, Cordeiro C, Dziedzic K, Edwards J, Grønhaug G, Higginbottom A, Lund H, Pacheco G, Pais S, Hagen KB. Self-reported quality care for knee osteoarthritis: comparisons across Denmark, Norway, Portugal and the UK. RMD Open. 2015 Oct 20;1(1):e000136. doi: 10.1136/rmdopen-2015-000136
Grønhaug G, Hagfors J, Borch I, Østerås N, Hagen KB. Perceived quality of health care services among people with osteoarthritis - results from a nationwide survey. Patient Prefer Adherence. 2015 Sep 3;9:1255–61. doi: 10.2147/PPA.S82441
Li LC, Sayre EC, Kopec JA, et al. Quality of nonpharmacological care in the community for people with knee and hip osteoarthritis. J Rheumatol 2011;38:2230–7. doi:10.3899/jrheum.110264
Acknowledgement Ann Karin Stensdotter and Helge Hartmann helped analyse the DR
Disclosure of Interest None declared