Telerehabilitation Perceptions and Experiences of Physiatrists in a Lower-Middle-Income Country during the COVID-19 Pandemic

PM R. 2021 Sep 28. doi: 10.1002/pmrj.12715. Online ahead of print.

ABSTRACT

BACKGROUND: The COVID-19 pandemic catalyzed the adoption of telerehabilitation in various healthcare settings. However, there was neither a pre-existing national guideline in the Philippines nor an internationally agreed standard on telerehabilitation. The literature lacks nationwide studies documenting how physiatrists perceived and experienced telerehabilitation during the pandemic.

OBJECTIVE: To determine the perceptions and experiences of physiatrists in the Philippines regarding telerehabilitation.

DESIGN: Online survey originally developed by the authors with inputs from local experts in telehealth or telerehabilitation.

SETTING: Nationwide, involving board-certified physiatrists practicing in the Philippines.

PARTICIPANTS: Fellows of the Philippine Academy of Rehabilitation Medicine (PARM) (N = 259) with Internet access.

MAIN OUTCOMES: Self-reported telerehabilitation knowledge, skills, and experience; key concerns; preferred clients, service offerings, and methods (technology, duration, charging).

RESULTS: The respondents (n = 161; 62.2% response-rate) had a mean age of 48.1±9.6 years, were mostly females (57.8%), and mostly practiced in private hospitals and urban settings. The majority reported inadequate telerehabilitation knowledge (61.5%), skills (58.4%), and experience (72.1%). The most common sources of telerehabilitation knowledge were colleagues (52.8%), PARM (51.6%), and telemedicine-related websites (41.6%). Most of the respondents preferred to conduct telerehabilitation with former patients over new ones, and prescribe telerehabilitation programs for physical, occupational, psychological, and speech-language therapy, but not for swallowing therapy. Videoconferencing was the most common telerehabilitation method. More than half of the respondents charged lesser fees for telerehabilitation compared to in-person consultations. While the majority recognized the need for telerehabilitation, their key concerns included the lack of thorough patient examination, and medicolegal liability issues.

CONCLUSION: Despite their limited baseline knowledge, skills and experience regarding telerehabilitation, many physiatrists in the Philippines learned to adopt this service delivery method during the pandemic. Their perceptions and experiences could be used in formulating practice-based guidelines and strategies to improve the conduct of telerehabilitation in the country. This article is protected by copyright. All rights reserved.

PMID:34585855 | DOI:10.1002/pmrj.12715