Improving primary care for persons with spinal cord injury: Development of a toolkit to guide care

The Journal of Spinal Cord Medicine, 2020 · DOI: 10.1080/10790268.2018.1468584 · Published: May 1, 2020

Simple Explanation

This study aimed to identify essential components for primary care of patients with spinal cord injury (SCI) to develop a practical toolkit for primary care practitioners (PCP). The toolkit would clarify which elements of SCI care are needed in primary care versus specialist care. A survey was conducted with family physicians, specialist physicians, and inter-disciplinary health professionals to rate the importance of various care elements for inclusion in the toolkit and to determine who should be responsible for each care category. The study identified important components of SCI care for inclusion in a point-of-practice toolkit to facilitate primary care for persons with SCI, emphasizing a shared care approach and capacity building among primary care providers.

Study Duration

Not specified

Participants

Three family physicians, six specialist physicians, and five inter-disciplinary health professionals

Evidence Level

Not specified

Key Findings

1
There was consensus among respondent groups on the importance of various care elements, with autonomic dysreflexia, pain, and skin care receiving the highest mean importance scores.
2
Family physicians should assume responsibility for assessing mental health, but opinions varied on who should be responsible for other care categories.
3
A shared care approach is needed in SCI care, with primary care providers screening for health issues and consulting with specialists as needed, along with inter-professional involvement.

Research Summary

This study aimed to develop a point-of-practice toolkit (SCIPCT) for primary care providers (PCP) to guide the assessment and management of patients with SCI. The purpose was to identify essential components of primary care for patients with SCI for inclusion in the SCIPCT. The study used a survey methodology to gather opinions from health professionals on essential components of care, consistent with the Delphi technique for obtaining consensus. The study concluded that capacity building and shared care approaches were identified as essential for enhancing SCI care at a primary care level. The study also identified important components of SCI care to be administered at a primary care level.

Practical Implications

Improved Primary Care

The development and implementation of the SCI Primary Care Toolkit (SCIPCT) can improve the quality of primary care for individuals with spinal cord injuries by providing a structured approach to assessment and management.

Shared Care Model

The study supports a shared care model between primary care physicians and specialists, ensuring that patients receive appropriate and timely care while optimizing the use of healthcare resources.

Capacity Building

The findings highlight the need for capacity building among primary care providers to enhance their knowledge and skills in managing SCI-related health issues, potentially reducing the need for specialist referrals and improving patient outcomes.

Study Limitations

1
The sample size could be considered low.
2
The survey respondents were all based in Ontario and therefore generalization to other healthcare jurisdictions may not apply.
3
Persons with SCI were not included in this study as previous and concurrent work has captured their feedback.

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