PTOTSystematic ReviewArchives of physical medicine and rehabilitation2023

Barriers and Facilitators to the Adoption of Evidence-Based Interventions for Adults Within Occupational and Physical Therapy Practice Settings: A Systematic Review.

Adam R Kinney, Kelly A Stearns-Yoder, Adam S Hoffberg and 5 others

PMID 36966954

WHAT IT FOUND

In occupational and physical therapy implementation studies, available resources were the most common barrier, and clinicians' knowledge and beliefs were the most common facilitator.

Adoption barriers varied by setting, and the review did not test actual uptake.

Key findings

01Available resources were the most common barrier to adoption, reported in 29 studies (64%).

02Knowledge and beliefs about the intervention were the most common facilitator, reported in 24 studies (53%).

03Inpatient studies identified intervention characteristics and inner setting as barriers more often than other settings.

STILL TO COME

How it was doneWhat they foundWhat it means for PTsWhat it means for OTs

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What it does not show

The review may have missed relevant studies despite a comprehensive search. Most study authors did not use CFIR, so determinants outside CFIR may have been missed. The review could not verify whether each intervention was truly evidence-based. All studies with quantitative procedures had high risk of bias. Most data were collected after implementation, and only 13 studies collected data before implementation. Only 17 studies used a theoretical framework. The included studies were from Western countries and mostly examined PT interventions, so they may not apply to OT practice or other health systems. The review did not link barriers or facilitators to measurable implementation outcomes or long-term sustainability.

Declared interests

The authors report no additional conflicts of interest.

The easy way to misread this

Do not read the list of barriers and facilitators as proof that an intervention works or that adding resources will make clinicians use it. The review did not link these determinants to measurable implementation outcomes, and it did not verify whether each intervention was truly evidence-based.

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