Use of patient-reported outcome measures for upper limb musculoskeletal conditions among physiotherapists in Tamil Nadu, India: a mixed-methods study

Resumo

Background Patient-reported outcome measures (PROMs) are widely recommended to evaluate function and participation among individuals with upper limb musculoskeletal conditions. There is scarce evidence about the use of PROMs in physiotherapy practice in India. We aimed to understand how physiotherapists use PROMs in patients with upper limb musculoskeletal conditions in Tamil Nadu, India. Methods A sequential explanatory mixed-methods study was conducted. An online survey was completed by 158 physiotherapists, followed by semistructured interviews with 12 participants to explore experiences and perceptions in depth. Results The mean age of the participants (n = 158) was 31.8 years. Twelve participants were interviewed (median age 35 years). Participants predominantly treated shoulder conditions and relied mainly on impairment-based assessments such as pain (76%), range of motion (70%), and muscle strength (59%). While 38% of the survey participants reported rarely or never using PROMs, all interview participants reported occasional use. Most survey participants were familiar with pain scales and unfamiliar with PROMs. Lack of time, knowledge, confidence in selecting and administering PROMs, and the non-availability of PROMs in Tamil were commonly reported barriers. Patient-related challenges such as literacy, language, and cooperation emerged in interviews. Availability of PROMs, therapist training, and workplace policies were the reported facilitators. Conclusions Our findings indicate that the use of PROMs and familiarity with them are reportedly low among physiotherapists in Tamil Nadu. Larger surveys are needed to guide policy, education, and professional practice to facilitate PROM use by physiotherapists in India.