The Canadian Occupational Performance Measure (COPM) as Routine Practice in Community-Based Rehabilitation: A Retrospective Chart Review

Glade Vyslysel; Daniel Barker; Isobel J Hubbard

doi:10.1016/j.arrct.2021.100134

The Canadian Occupational Performance Measure (COPM) as Routine Practice in Community-Based Rehabilitation: A Retrospective Chart Review

Arch Rehabil Res Clin Transl. 2021 May 24;3(3):100134. doi: 10.1016/j.arrct.2021.100134. eCollection 2021 Sep.

Authors

Glade Vyslysel¹, Daniel Barker², Isobel J Hubbard²

Affiliations

¹ Hunter New England Local Health District, Westlakes Community Rehabilitation Team, Toronto, NSW.
² School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia.

Abstract

Objective: To investigate whether patients experienced improved functional outcomes as a result of their admission to rehabilitation and to identify whether the service provided effective, patient-centered and goal-directed rehabilitation.

Design: Retrospective chart review of admission and discharge data from patients accessing the service between 2011 and 2019.

Setting: Community-based interdisciplinary rehabilitation service.

Participants: Consecutive patients (N=612) admitted to the service.

Interventions: Routine care delivered with a median duration of 181 days and an interquartile range of 120-261 days.

Main outcome measures: The Canadian Occupational Performance Measure (COPM) administered on admission and discharge and an improvement ≥2 in the COPM subscales of performance and satisfaction.

Results: Of 612 participants, 96% had the COPM administered at admission (baseline) and 68% again at discharge. Performance and satisfaction were measured in 584 patients at admission, 406 at discharge, and 404 at both time points. For performance, 243 patients (60%) experienced an improvement (≥2), with an average of 2.2 points. For satisfaction, 268 patients (66%) experienced an improvement (≥2), with an average of 2.8 points. Factors influencing outcomes, differed. For each 10 year increase in patient age, the average improvement in satisfaction was 0.26 points lower (95% confidence interval, 0.07-0.45) after adjusting for sex, duration, completion, and health condition.

Conclusions: Irrespective of patient-related factors and regardless of age, sex, health condition, or discharge plan, the majority of patients reported a positive functional outcome in COPM Performance and satisfaction as a result of time spent in the community-based rehabilitation service. This service provided equitable care and patient-centered, goal-focused, and outcome-based therapy that enabled patients to improve their functional capacity.

Keywords: CI, confidence interval; COPM; COPM, Canadian Occupational Performance Measure; Interdisciplinary; Patient-reported outcome measures; Rehabilitation; Stroke; WCRT, Westlakes Community Rehabilitation Team.