Patient satisfaction with virtual evaluation, diagnosis, and treatment of CRPS.

Background: The COVID-19 pandemic has led to an increased reliance on virtual care in the rehabilitation setting for patients with conditions such as complex regional pain syndrome (CRPS). Aims: The aim of this study was to perform a quality improvement initiative to assess patient satisfaction and ensure that outcomes following virtual assessment, diagnosis, and treatment of CRPS with prednisone are safe and effective. Methods: An online survey was distributed to 18 patients with CRPS who had been seen virtually between March and December 2020 through a rehabilitation clinic and treated with oral prednisone. Thirteen participants completed the survey, which was designed de novo by our team to evaluate participant perceptions and satisfaction regarding the virtual care experience. Also included in the survey was a CRPS-specific validated patient-report questionnaire (Hamilton Inventory for CRPS: PR-HI-CRPS), which allowed participants to describe their specific symptoms and associated functional and psychosocial impacts, both previously (pretreatment baseline) and at the time of survey (posttreatment). Results: CRPS symptoms and related impacts were scored as significantly improved from baseline following treatment with prednisone. Likert scale results from survey responses related to patients' experiences and satisfaction with the virtual care process were analyzed; the majority of patients reported satisfaction with a virtual appointment for evaluation of CRPS, as well as with subsequent treatment decisions based on virtual assessment. Conclusions: This quality improvement study suggests that virtual care is a potential option for a patient-accepted approach to overcoming challenges with in-person care imposed by the COVID-19 pandemic and could help inform future considerations in addressing geographic and patient-specific disparities in access to specialist care for CRPS.

Contexte: La pandémie de COVID-19 a donné lieu à un recours accru aux soins de réadaptation virtuels pour les patients souffrant d'affections telles que le syndrome douloureux régional complexe (SDRC).Objectifs: L'objectif de cette étude était de réaliser une initiative d'amélioration de la qualité afin d'évaluer la satisfaction des patients et de veiller à ce que les suites à l'évaluation, au diagnostic et au traitement virtuel du SDRC par la prednisone soit sûres et efficaces.Méthodes : Un sondage en ligne a été distribué à 18 patients atteints de SDRC qui avaient été vus virtuellement entre mars et décembre 2020 par le biais d'une clinique de rééducation et qui avaient été traités par prednisone orale. Treize participants ont répondu au sondage, qui avait été conçu de novo par notre équipe, afin d'évaluer les perceptions et la satisfaction des participants à l'égard de leur expérience de soins virtuels. Le sondage comprenait aussi un questionnaire validé par le patient propre au SDRC, (le Hamilton Inventory for CRPS: PR-HI-CRPS), qui a permis aux participants de décrire leurs symptômes spécifiques, ainsi que les effets fonctionnels et psychosociaux qui y étaient associés précédemment (avant le traitement) et à la date de l'enquête (post-traitement).Résultats: Les notes accordées par les participants ont révélé que les symptômes du SDRC et leurs répercussions s'étaient significativement améliorés aprés le traitement par la prednisone. Les résultats sur l'échelle de Likert découlant des réponses aux questions de l'enquête sur l'expérience des patients et leur satisfaction à l'égard du processus de soins virtuels ont été analysés. La majorité des patients se sont déclarés satisfaits du rendez-vous virtuel pour l'évaluation du SDRC, ainsi que des décisions de traitement ultérieures basées sur l'évaluation virtuelle.Conclusions: Cette étude d'amélioration de la qualité suggére que les soins virtuels sont une option envisageable en tant qu'approche acceptée par le patient pour surmonter les difficultés liées aux soins en personne imposées par la pandémie de COVID-19. Elle pourrait donc aider à éclairer les considérations futures dans le traitement des disparités géographiques et les celles qui sont spécifiques aux patients dans l'accés aux soins spécialisés pour le SDRC.

Publication Rate of Presentations at a National Physical Medicine and Rehabilitation Scientific Conference From 2009 to 2018.

ABSTRACT: Conferences are important platforms for sharing research, but full-text publication is necessary for broader dissemination and impact. Few studies have examined the abstract-to-publication rate for physical medicine and rehabilitation. This study aimed to determine the abstract-to-publication rate of research abstracts presented from 2009-2018 at the Canadian Association of Physical Medicine and Rehabilitation annual scientific meetings. Using the official book of abstracts from 2009 to 2018, year of conference, abstract title, author names, and the affiliation/level of training of the first author were extracted. Systematic searches of abstract key words, authors' names, and the abstract title were performed using PubMed and Google Scholar to determine whether an abstract proceeded to full-text publication; if so, the date and journal of publication were extracted. Of the 524 total abstracts presented at the Canadian Association of Physical Medicine and Rehabilitation from 2009 to 2018, 187 went on to full-text publication for an abstract-to-publication rate of 35.8%. The mean time to full-text publication was 23.4 ± 8.63 mos. The abstract-to-publication rate was 18.6% for medical students, 28.7% for residents, 41.1% for physical medicine and rehabilitation consultants, and 49.4% for nonphysician presenters. This study highlights that low abstract-to-publication rates for novel research presented at the Canadian Association of Physical Medicine and Rehabilitation disproportionately affects trainees. Further research is needed to identify and remedy barriers to publication.

Changes to Rehabilitation Service Delivery and the Associated Physician Perspectives During the COVID-19 Pandemic: A Mixed-Methods Needs Assessment Study.

This project aimed to determine the impact of and needs from physician members of the Canadian Association of Physical Medicine & Rehabilitation during the early response to the COVID-19 global pandemic. The purpose of this project was to develop a framework for addressing the pandemic tailored to the needs of Canadian physiatrists. A convergent mixed-methods design was used for this needs assessment quality project. A total of 136 responses were obtained with an overall response rate of 34%. Three major themes were identified relating to the impact of COVID-19 on physicians: (1) changes to direct patient care, (2) changes to nonclinical aspects of physician's practices, and (3) impacts on personal and family well-being. Three requests for Canadian Association of Physical Medicine & Rehabilitation support during the pandemic were as follows: (1) collaborative sharing of information and resources, (2) advocacy for both patients and providers, and (3) avenues for social connection and wellness. This project provided insight into the impact of COVID-19 and current needs of Canadian Association of Physical Medicine & Rehabilitation physicians. The results were used to develop a solutions framework including guidance on use of virtual care and holding education webinars on high-yield topics. Next steps include a follow-up survey on change in preparedness and member satisfaction with the Canadian Association of Physical Medicine & Rehabilitation response.