Quality of care and patient‐reported outcomes in carpal tunnel syndrome: A prospective observational study

ABSTRACT Introduction: Higher quality care for carpal tunnel syndrome (CTS) may be associated with better outcomes. Methods: This prospective observational study recruited adults diagnosed with CTS from 30 occupational health centers, evaluated physicians' adherence to recommended care processe...

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Published inMuscle & nerve Vol. 57; no. 6; pp. 896 - 904
Main Authors Nuckols, Teryl K., Conlon, Craig, Robbins, Michael, Dworsky, Michael, Lai, Julie, Roth, Carol P., Levitan, Barbara, Seabury, Seth, Seelam, Rachana, Benner, Douglas, Asch, Steven M.
Format Journal Article
LanguageEnglish
Published United States Wiley Subscription Services, Inc 01.06.2018
Subjects
Adult
Adults
Aged
Carpal tunnel syndrome
Carpal Tunnel Syndrome - therapy
Confidence intervals
Female
functional status
Health Surveys
Humans
Male
Medical personnel
Middle Aged
Muscles
Observational studies
occupational diseases
Occupational health
outcomes
Overuse injuries
Patient Reported Outcome Measures
Patient Satisfaction
Patients
Physicians
Prospective Studies
Quality of care
Quality of Health Care
Surgery
Surveys and Questionnaires
carpal tunnel syndrome
functional status
outcomes
quality of care
occupational diseases
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Summary:ABSTRACT Introduction: Higher quality care for carpal tunnel syndrome (CTS) may be associated with better outcomes. Methods: This prospective observational study recruited adults diagnosed with CTS from 30 occupational health centers, evaluated physicians' adherence to recommended care processes, and assessed results of the Boston Carpal Tunnel Questionnaire (BCTQ) and Short Form Health Survey version 2 (SF‐12v2) at recruitment and at 18 months. Results: Among 343 individuals, receiving better care (80th vs. 20th percentile for adherence) was associated with greater improvements in BCTQ Symptom Severity scores (−0.18, 95% confidence interval [CI] −0.32 to −0.05), BCTQ Functional Status scores (−0.21, 95% CI −0.34 to −0.08), and SF12‐v2 Physical Component scores (1.75, 95% CI 0.33–3.16). Symptoms improved more when physicians assessed and managed activity, patients underwent necessary surgery, and employers adjusted job tasks. Discussion: Efforts should be made to ensure that patients with CTS receive essential care processes including necessary surgery and activity assessment and management. Muscle Nerve 57: 896–904, 2018
Bibliography:Conflicts of Interest
Funding
This work was supported by a grant from the Agency for Healthcare Research and Quality (5R01HS018982). Prior stages in the work were supported with funding from the California Commission on Health and Safety and Workers' Compensation and Zenith Insurance. The funders played no role in the design, conduct, or reporting of this work.
RAND has received funding for Dr Nuckols' work from iCare New South Wales, a public financial enterprise that delivers insurance and care to individuals in New South Wales, Australia. Dr Benner is employed by EK Health Inc and is affiliated with Macy's, Inc and Marriott International. The remaining authors have no conflicts of interest to disclose. The funders played no role in the design, conduct, or reporting of this work.
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ISSN:0148-639X
1097-4598
DOI:10.1002/mus.26041