Predicting the number of physical therapy visits and patient satisfaction in individuals with temporomandibular disorder: A cohort study

• Published in: Journal of oral rehabilitation Vol. 49; no. 1; pp. 22 - 36
• Main Authors: Prodoehl, Janey, Kraus, Steven, Buros Stein, Amy
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.01.2022
• Subjects: Cohort analysis; Cohort Studies; episode of care; Gender; Health care; Humans; interdisciplinary; Neck; Pain; Patient Satisfaction; Patients; Physical therapy; Physical Therapy Modalities; Prediction models; temporomandibular joint disorders; Temporomandibular Joint Disorders - therapy; Treatment Outcome; patient satisfaction; episode of care; temporomandibular joint disorders; treatment outcome; interdisciplinary
• ISSN: 0305-182X; 1365-2842
• DOI: 10.1111/joor.13272

Background Temporomandibular disorders (TMD) can be challenging to manage for clinicians and patients alike. It is unclear which factors are associated with prolonging conservative care and patient dissatisfaction with treatment outcomes. Objectives To examine factors collected during a physical therapy (PT) evaluation in a cohort of individuals with TMD to determine factors associated with an increased number of PT visits and reduced patient satisfaction. Methods Records of 511 patients referred to PT over 18 months were reviewed to extract 27 variables to develop a predictive model. Outcomes were patient satisfaction following PT and number of PT visits. Linear and zero inflated negative binomial regressions were used, and a multivariate regression model was built for both outcomes. Results Two factors were associated with both lower patient satisfaction and an increased number of PT visits: higher patient rated functional neck disability and a greater number of healthcare professionals seen. Other factors associated with patient satisfaction were duration of symptoms, subluxation, and referral from an oral surgeon. Only patient rated functional neck disability score was a significant predictive factor in the multivariate model. Factors associated with number of PT visits were gender, educational level, time between initial visit and discharge, number of pain areas, bruxism, biopsychosocial factors, dizziness, pain rating, and presence of neck pain. In the multivariate model, gender, number of healthcare professionals seen, and resting pain rating were significant predictors of number of PT visits. Conclusion Considering key factors on initial evaluation, specifically functional neck disability and the number of prior healthcare professionals seen before starting PT, can help to predict a higher number of PT visits and reduced patient satisfaction with outcomes. Factors collected during a physical therapy (PT) evaluation in a cohort of individuals with temporomandibular disorder (TMD) were used to determine factors associated with an increased number of PT visits and reduced patient satisfaction. Female patients who saw a higher number of healthcare professionals prior to starting PT and who had a higher pain rating significantly predicted an increased number of PT visits. Considering the presences of functional neck disability and the number of prior healthcare professionals seen before starting PT can help to predict a higher number of care visits and reduced patient satisfaction with outcomes.