Understanding Behavior Change in Clinical Practice Guideline Implementation: A Qualitative Study.
Julie K Tilson, Clarisa Martinez, Sharon Mickan and 7 others
PMID 39656160WHAT IT FOUND
Therapists said monthly team meetings with concrete audit feedback kept them on track.
Patients said personalized handouts and therapists asking about home exercises boosted their adherence. Neither group liked rigid systems or text-message reminders that were too complex to use.
Key findings
01Therapists valued monthly meetings that combined chart audit feedback with case discussions, describing them as essential for maintaining accountability and standardizing care.
02Patients reported that therapists asking about home exercise adherence each visit and providing personalized handouts with pictures motivated them to continue their rehabilitation.
03Text-message reminder systems and rigid documentation tools were described by therapists as too complex and adaptable to sustain, often leading to frustration rather than adherence.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study included only 16 therapists and 12 patients from five sites, so the findings may not apply to other clinics or disciplines. Patients were interviewed by Site Leads or research assistants new to qualitative interviewing, which may have affected the depth of the data. Therapists were interviewed up to 11 months after the intervention, so some details may have been forgotten or reconstructed. The study reports experiences and perceptions, not clinical outcomes or changes in patient health.
Declared interests
The study was funded by the Academy of Neurologic Physical Therapy (ANPT), which developed the guideline being implemented.
The easy way to misread this
Do not interpret these themes as evidence that these strategies improve patient health outcomes. The study describes what therapists and patients said they experienced, not whether the intervention worked.