Critical perspectives on implementation of evidence-based practice in occupational therapy - Exemplified by Lifestyle Redesign® in a Danish context.
Stinne Glasdam, Jeppe Oute, Sigrid Stjernswärd
PMID 40337081WHAT IT FOUND
A Danish Lifestyle Redesign® project simplified a US trial to five participants with no control group, yet recommended widespread implementation.
This weak evidence base risks undermining occupational therapy's scientific credibility and professional recognition.
Key findings
01The Danish practice development project drastically reduced the original US RCT design, moving from 361 participants and randomised controls to a single group of nine people (five completed) with no randomisation or control arm.
02Despite the weak scientific design and lack of comparative analysis, the Danish project authors concluded the programme was effective and recommended its implementation in Danish municipalities, a stance the current paper argues compromises the profession's academic credibility.
03The original US Lifestyle Redesign® RCT demonstrated significant benefits and cost-effectiveness for preventive OT, but these findings were not replicated with scientific rigour in the Danish context.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The study is a secondary analysis of published texts and reports, not primary data collection. The analysis is limited to one specific case (Lifestyle Redesign® in Denmark vs. USA), so findings may not generalise to other interventions or contexts. The authors acknowledge that the CONSORT checklist was used with minor deviations, omitting some questions deemed non-essential. The material analysed dates from a period when occupational therapy education in Denmark was not yet at master's level, which may contextualise the methodological weaknesses.
Declared interests
The authors received no financial support for the research, authorship, or publication of this article.
The easy way to misread this
Do not interpret the Danish project's recommendation for widespread implementation as evidence that Lifestyle Redesign® works in that context. The recommendation was based on five participants with no control group and no statistical analysis, whereas the original US trial used 361 participants and randomised controls to demonstrate efficacy.