Abstract
BACKGROUND: Patients recovering from COVID-19 often experience persistent problems in their daily activities related to limitations in physical, nutritional, cognitive, and mental functioning. To date, it is unknown what treatment is needed to support patients in their recovery from COVID-19.
OBJECTIVE: This study aimed to evaluate the primary allied health care of patients recovering from COVID-19 at 6-month follow-up and to explore which baseline characteristics are associated with changes in the scores of outcomes between baseline and 6-month follow-up.
METHODS: This Dutch nationwide prospective cohort study evaluated the recovery of patients receiving primary allied health care (ie, dietitians, exercise therapists, occupational therapists, physical therapists, and speech and language therapists) after COVID-19. All treatments offered by primary allied health professionals in daily practice were part of usual care. Patient-reported outcome measures on participation, health-related quality of life, fatigue, physical functioning, and psychological well-being were assessed at baseline and at 3- and 6-month follow-up. Linear mixed model analyses were used to evaluate recovery over time, and uni- and multivariable linear regression analyses were used to examine the association between baseline characteristics and recovery.
RESULTS: A total of 1451 adult patients recovering from COVID-19 and receiving treatment from 1 or more primary allied health professionals were included. For participation (Utrecht Scale for Evaluation of Rehabilitation-Participation range 0-100), estimated mean differences of at least 2.3 points were observed at all time points. For the health-related quality of life (EuroQol Visual Analog Scale, range 0-100), the mean increase was 12.3 (95% CI 11.1-13.6) points at 6 months. Significant improvements were found for fatigue (Fatigue Severity Scale, range 1-7): the mean decrease was -0.7 (95% CI -0.8 to -0.6) points at 6 months. However, severe fatigue was reported by 742/929 (79.9%) patients after 6 months. For physical functioning (Patient-Reported Outcomes Measurement Information System-Physical Function Short Form 10b, range 13.8-61.3), the mean increase was 5.9 (95% CI 5.9-6.4) points at 6 months. Mean differences of -0.8 (95% CI -1.0 to -0.5) points for anxiety (Hospital Anxiety and Depression Scale range 0-21) and -1.6 (95% CI -1.8 to -1.3) points for depression were found after 6 months. A worse baseline score, hospital admission, and male sex were associated with greater improvement between baseline and 6-month follow-up, whereas age, the BMI, comorbidities, and smoking status were not associated with mean changes in any outcome measures.
CONCLUSIONS: Patients recovering from COVID-19 who receive primary allied health care make progress in recovery but still experience many limitations in their daily activities after 6 months. Our findings provide reference values to health care providers and health care policy makers regarding what to expect from the recovery of patients who receive health care from 1 or more primary allied health professionals.
TRIAL REGISTRATION: ClinicalTrials.gov NCT04735744; https://tinyurl.com/3vf337pn.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2340/jrm.v54.2506.
| Original language | English |
|---|---|
| Article number | e44155 |
| Pages (from-to) | e44155 |
| Journal | JMIR Public Health and Surveillance |
| Volume | 9 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - 20 Oct 2023 |
Bibliographical note
©Anne I Slotegraaf, Marissa H G Gerards, Arie C Verburg, Marian A E de van der Schueren, Hinke M Kruizenga, Maud J L Graff, Edith H C Cup, Johanna G Kalf, Antoine F Lenssen, Willemijn M Meijer, Renée A Kool, Rob A de Bie, Philip J van der Wees, Thomas J Hoogeboom, Dutch Consortium Allied Healthcare COVID-19. Originally published in JMIR Public Health and Surveillance (https://publichealth.jmir.org), 20.10.2023.Funding
The authors would like to thank all patients and primary allied health professionals for reporting their data. We would like to thank the professional bodies of the primary allied health professionals in optimizing patient inclusion and the advisory board of the project for their input from their stakeholders’ perspective. We would also like to thank all research staff for support with the collection of data, data cleaning, and statistical advice. Finally, we would like to thank all remaining collaborators from the Dutch Consortium Allied Healthcare COVID-19 for their contribution: Carla Agasi-Idenburg, Johanna M van Dongen, Edwin Geleijn, Ron van Heerde, Anja de Kruif, Marike van der Leeden, Raymond W J G Ostelo, Amber Ronteltap, Marike van der Schaaf, Sonja van Oers, and Cindy Veenhof. This project was funded by ZonMw Efficiency Studies (10390062010001) and received additional funding for setting up the data collection tool by the Royal Dutch Society for Physiotherapy, the Association for Quality in Physical Therapy, the Nivel Netherlands Institute for Health Services Research, Stichting Revalidatie en Wetenschap, and Maastricht University.
| Funders | Funder number |
|---|---|
| Association for Quality in Physical Therapy | |
| Carla Agasi-Idenburg | |
| Dutch Consortium Allied Healthcare COVID-19 | |
| Nivel Netherlands Institute for Health Services Research | |
| Royal Dutch Society for Physiotherapy | |
| Stichting Revalidatie en Wetenschap | |
| ZonMw Efficiency Studies | 10390062010001 |
| Universiteit Maastricht |
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