A guideline-based preference elicitation tool to enhance shared decision-making in supervised exercise therapy for...

Area of Science:

• Physical Therapy
• Health Services Research
• Implementation Science

Background:

• A preference elicitation tool was introduced to Dutch physical therapists to support person-centered care for intermittent claudication.
• The tool aims to enhance patient-therapist dialogue and collaborative treatment planning.
• Understanding adoption factors is crucial for successful integration into physical therapy practice.

Purpose of the Study:

• Evaluate the adoption and reach of the preference elicitation tool among physical therapists.
• Identify perceived barriers and facilitators influencing tool adoption.

Main Methods:

• A multi-method process evaluation was conducted.
• Quantitative data assessed adoption (e-learning completion, tool usage) and reach (patient usage).
• Qualitative semi-structured interviews with 11 therapists identified barriers and facilitators using the Tailored Implementation for Chronic Diseases framework.

Main Results:

• 64% of eligible therapists completed the e-learning module, and 45% started using the tool.
• The tool was used with 38% of eligible intermittent claudication patients.
• 39 barriers (e.g., time, role conflict) and 37 facilitators (e.g., user-friendliness, flexibility) were identified.

Conclusions:

• Modest adoption and reach rates highlight areas for improvement in implementing the preference elicitation tool.
• Therapists' adoption decisions were influenced by factors like time, communication comfort, and perceived role fit.
• Strategies supporting flexible tool use and further research into patient perspectives are recommended.