Health Services Research and Occupational Therapy: Ensuring Quality and Cost-Effectiveness

An international study of diversity in occupational therapy research- A bibliographic review of English research literature

BACKGROUND

The cornerstone of a strong profession is the research that supports its knowledge base and practice. However, little is known about the range of international occupational therapy research.

OBJECTIVE

To explore the range and diversity of the international occupational therapy research from published peer reviewed literature in English during the year 2018.

METHODOLOGY

Limited to 2018, a review was conducted of sources from i) health-related search engines using search terms associated with occupational therapy practice, and ii) content pages of occupational therapy publications. Articles were excluded if they i) had no occupational therapy author, ii) were not peer reviewed, iii) not in English, and iv) did not include primary data collection (e.g., opinion pieces, position statements, study protocols). Of articles selected for analysis, data were extracted and synthesized according to the study's origin country, publishing research journal, the characteristics of the represented research, and its alignment with World Federation of Occupational Therapists research priorities.

RESULTS

A total of 4,169 articles were retrieved from the search (i.e., 3,459 from health-related search engines and 710 through a manual search of occupational therapy journals). After exclusions, 2,345 articles were included for analysis.

CONCLUSION

The review identified English published research was predominantly conducted in economically privileged countries. In addition, it revealed several research priorities that need further development such as evaluating the effectiveness of occupational therapy interventions.

Occupational Therapy Practice Guidelines for Adults Living With Alzheimer's Disease and Related Neurocognitive Disorders

IMPORTANCE

There are currently 55 million adults living with declining functional cognition-altered perception, thoughts, mood, or behavior-as the result of Alzheimer's disease (AD) and related neurocognitive disorders (NCDs). These changes affect functional performance and meaningful engagement in occupations. Given the growth in demand for services, occupational therapy practitioners benefit from consolidated evidence of effective interventions to support adults living with AD and related NCDs and their care partners.

OBJECTIVE

These Practice Guidelines outline effective occupational therapy interventions for adults living with AD and related NCDs and interventions to support their care partners.

METHOD

We synthesized the clinical recommendations from a review of recent systematic reviews.

RESULTS

Twelve systematic reviews published between 2018 and 2021 served as the foundation for the practice recommendations.

CONCLUSION AND RECOMMENDATIONS

Reminiscence, exercise, nonpharmacological behavioral interventions, cognitive therapy, sensory interventions, and care partner education and training were found to be most effective to support adults living with AD and related NCDs. Plain-Language Summary: These Practice Guidelines provide strong and moderate evidence for occupational therapy practitioners to support adults living with Alzheimer's disease (AD) and related neurocognitive disorders (NCDs) and their care partners. They provide specific guidance for addressing the decline in cognition, behavioral and psychological symptoms of dementia, and pain experience of adults living with AD and related NCDs. The guidelines also describe interventions to support care partners. With support from the evidence, occupational therapy practitioners are better equipped to address the unique needs of adults living with AD and related NCDs and their care partners.

Elizabeth Casson Memorial Lecture 2022: Optimising performance, clinical and economic outcomes in occupational therapy service delivery

The rise in health and social care costs has prompted a critical look at the way health and social care services are managed and delivered. There has been a significant change in assessing the performance and evaluating the outcomes of services. Where once only performance outcome data related to service efficiency were required, now evidence of clinical effectiveness and cost-effectiveness is demanded. When evaluating the outcomes of service delivery, it is important to measure performance outcomes (related to service efficiency), clinical outcomes (related to service effectiveness) and economic outcomes (related to cost-effectiveness). This lecture examines the interdependent relationship between performance, clinical and economic outcomes in service delivery which is underpinned by strong leadership, the application of various service improvement strategies and collaborative research between managers, clinicians, researchers and health economists, with patient and public involvement. Service improvement strategies based on practice-based and research-based evidence will be suggested to optimise performance, clinical and economic outcomes. My lecture concludes that occupational therapists should adopt these service improvement strategies and conduct clinical researches and economic evaluations to develop an efficient, effective and cost-effective service which can meet the client’s needs by using allocated resources and is value for money from a commissioning perspective.