Determinants to the use of patient-reported outcome measures to manage neck and lower back pain among physiotherapists

Background and purpose: Low back pain (LBP) and neck pain (NP) are prevalent conditions in Hong Kong, but physiotherapists’ use and determinants of patient-reported outcome measures (PROMs) have not been studied. This study explored the use of PROMs and identified its determinants to devise an implementation strategy.
Methods: This is two-phase mixed-method study. Phase I used the Theoretical Domains Framework (TDF) to survey local musculoskeletal physiotherapists on PROM use and its determinants. Based on the Phase I findings, Phase II involved a focus group of experts to develop a plan for implementation using behavior change techniques.
Results: A total of 39 physiotherapists, 46.2% of whom worked for the Hospital Authority and had an average of 11.40 years of experience, were surveyed. Eight facilitators were identified and mapped to eight TDF domains: knowledge; social/
professional role and identity; beliefs about capabilities; beliefs about consequences; reinforcement; goals; social influences; and emotion. Nine barriers were identified and mapped to eight TDF domains: knowledge; skills; beliefs about capabilities; beliefs about consequences; reinforcement; goals; environmental context and resources; and behavior regulations. An implementation strategy was tailored to address these barriers.
Conclusion: This is the first study to investigate the use of PROMs by local
musculoskeletal physiotherapists in in the management of LBP and NP. Facilitators and barriers were identified and mapped to the pertinent TDF domains and behavior change techniques. To improve the routine use of PROMs and maximize the quality of care for patients with LBP and NP, a strategy for implementation was developed.