Ms Sheridan Guyatt1
1Mater Health, South Brisbane, Australia
Lumbopelvic pain (LPP) is the most common musculoskeletal condition in pregnancy with a prevalence of up to 65%. Systematic reviews conclude that timely patient education and guided self-management are effective components of Physiotherapy management of this condition; however, timely intervention in an outpatient (OPD) setting is a challenge.
To facilitate timely intervention in an oversubscribed physiotherapy outpatient clinic at the Mater Mothers Hospital (MMH), electronic health (eHealth) was identified as a viable adjunct. A review of literature revealed that pregnant women access most of their health-related information online and physiotherapy eHealth interventions during pregnancy have been shown to increase adherence to prescribed self-management programs.
In January 2018 a new countermeasure was implemented: patients presenting with mild to moderate LPP symptoms were sent a personalised email, including self-management information and a video (https://youtu.be/E7Yi8rL7ZDU) providing clear guidelines to facilitate techniques for moving, stretching and postures during and after pregnancy. Patients who received the eHealth package were advised that if significant LPP persisted after two weeks of self-management to re-contact the Physiotherapy department for an urgent OPD appointment. Patients presenting with severe LPP were immediately booked an OPD appointment.
The new process reduced face to face antenatal physiotherapy OPD activity by 9.4% compared to the previous year. Patients requiring urgent treatment can now be offered appointments within an appropriate timeframe (< 1 week). Patient acceptability of this tiered eHealth program is high and further evaluation of the effectiveness in managing LPP is currently being assessed.
This quality improvement project demonstrates that eHealth is an effective tool for managing OPD waiting times and is an acceptable method of managing mild to moderate LPP in pregnancy. eHealth, as the first line of treatment, has the potential to extend to other caseloads where education and self-management are integral to care.
Sheridan is a Physiotherapist with over 25 years’ experience working with pregnant and postnatal women in both public and private settings here in Queensland and also in Tasmania. She is currently the Team Leader for the Mothers, Women’s and Pelvic Health Physiotherapy Team at the Mater Mothers Hospital, South Brisbane where over 10 000 babies are born each year. Sheridan is completing a PhD through the Faculty of Medicine, University of Queensland. She is passionate about interdisciplinary practise, effective patient communication and how together we can achieve great outcomes for expectant and new parents.