Organization of Rehabilitation Services in Randomized Controlled Trials: Which Factors Influence Functional Outcome? A Systematic Review

Cecilie Røe, PhD; Erik Bautz-Holter, PhD; Nada Andelic, PhD; Helene Lundgaard Søberg, PhD; Boya Nugraha, PhD; Christoph Gutenbrunner, PhD; Andrea Boekel, PhD; Marit Kirkevold, PhD; Grace Engen, MPhil; Juan Lu, PhD

Archives of Rehabilitation Research and Clinical Translation (Jun 2022)

Organization of Rehabilitation Services in Randomized Controlled Trials: Which Factors Influence Functional Outcome? A Systematic Review

Cecilie Røe, PhD,
Erik Bautz-Holter, PhD,
Nada Andelic, PhD,
Helene Lundgaard Søberg, PhD,
Boya Nugraha, PhD,
Christoph Gutenbrunner, PhD,
Andrea Boekel, PhD,
Marit Kirkevold, PhD,
Grace Engen, MPhil,
Juan Lu, PhD

Affiliations

Cecilie Røe, PhD: Research Centre for Habilitation and Rehabilitation Models and Services (CHARM), Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Corresponding author Cecilie Røe, Research Centre for Habilitation and Rehabilitation Models and Services (CHARM), Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway, P.O. Box 1089, Blidern, 0319 Oslo, Norway.
Erik Bautz-Holter, PhD: Research Centre for Habilitation and Rehabilitation Models and Services (CHARM), Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
Nada Andelic, PhD: Research Centre for Habilitation and Rehabilitation Models and Services (CHARM), Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
Helene Lundgaard Søberg, PhD: Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway; Department of Physiotherapy, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
Boya Nugraha, PhD: Department of Rehabilitation Medicine, Hannover Medical School, Hanover, Germany
Christoph Gutenbrunner, PhD: Department of Rehabilitation Medicine, Hannover Medical School, Hanover, Germany
Andrea Boekel, PhD: Department of Rehabilitation Medicine, Hannover Medical School, Hanover, Germany
Marit Kirkevold, PhD: Research Centre for Habilitation and Rehabilitation Models and Services (CHARM), Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway; Institute of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet University, Oslo, Norway
Grace Engen, MPhil: Research Centre for Habilitation and Rehabilitation Models and Services (CHARM), Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
Juan Lu, PhD: Department of Family Medicine and Population Health, Division of Epidemiology, Virginia Commonwealth University, Richmond, Virginia

Journal volume & issue: Vol. 4, no. 2
p. 100197

Abstract

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Objective: To identify factors related to the organization of rehabilitation services that may influence patients’ functional outcome and make recommendations for categories to be used in the reporting of rehabilitation interventions. Data Sources: A systematic review based on a search in MEDLINE indexed journals (MEDLINE [OVID], Cumulative Index of Nursing and Allied Health Literature, PsycINFO, Cochrane Central Register of Controlled Trials) until June 2019. Study Selection: In total 8587 candidate randomized controlled trials reporting on organizational factors of multidisciplinary rehabilitation interventions and their associations with functional outcome. An additional 1534 trials were identified from June 2019 to March 2021. Data Extraction: Quality evaluation was conducted by 2 independent researchers. The organizational factors were classified according to the International Classification for Service Organization in Health-related Rehabilitation 2.0. Data Synthesis: In total 80 articles fulfilled the inclusion criteria. There was a great heterogeneity in the terminology and reporting of service organization across all studies. Aspects of Settings including the Mode of Service Delivery was the most explicitly analyzed organizational category (44 studies). The importance of the integration of rehabilitation in the inpatient services was supported. Furthermore, several studies documented a lack of difference in outcome between outpatient vs inpatient service delivery. Patient Centeredness, Integration of Care, and Time and Intensity factors were also analyzed, but heterogeneity of interventions in these studies prohibited aggregation of results. Conclusions: Settings and in particular the way the services were delivered to the users influenced functional outcome. Hence, it should be compulsory to include a standardized reporting of aspects of service delivery in clinical trials. We would also advise further standardization in the description of organizational factors in rehabilitation interventions to build knowledge of effective service organization.

Rehabilitation

Published in Archives of Rehabilitation Research and Clinical Translation

ISSN: 2590-1095 (Online)
Publisher: Elsevier
Country of publisher: Netherlands
LCC subjects: Medicine: Medicine (General)
Website: https://www.journals.elsevier.com/archives-of-rehabilitation-research-and-clinical-translation

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