Evaluation of occupational therapy in persons with COVID-19: a pre-post observational cohort study.

BACKGROUND

Persons with COVID-19 may experience limitations in daily functioning and can be referred to occupational therapy.

OBJECTIVES

To evaluate changes in daily functioning, cognitive complaints, fatigue and self-management of persons with COVID-19 who received occupational therapy in primary care.To get insights in the volume and duration of occupational therapy.

DESIGN

A pre-post observational cohort study from October 2020 until April 2021.

SETTING

Fifty-eight occupational therapy practices in primary care throughout the Netherlands participated with 68 occupational therapists.

PARTICIPANTS

228 adults (≥18 years) with COVID-19, referred to occupational therapy, gave informed consent and participated in the pre-post evaluation. The mean age was 49 years (SD 13) and 79% of the patients was female. The most frequently reported complaints included fatigue and cognitive complaints.

INTERVENTIONS

Occupational therapy using Dutch guidelines for occupational therapy in clients with COVID-19.

OUTCOME MEASURES

Performance and satisfaction with performance using the Canadian Occupational Performance Measure (COPM); the impact of Cognitive Complaints on Participation (CoCo-P); and daily activities, self-management and perceived contribution of occupational therapy using the Patient Reported Outcome Measure for Occupational Therapy (PROM-OT).

RESULTS

COPM-performance score improved with a mean difference of 2.9 points (95% CI 2.7 to 3.2), and COPM-satisfaction score improved with 3.2 points (95% CI 2.9 to 3.5). CoCo-P score improved with a mean difference of 20.9 points (95% CI from 14.4 to 27.4), and PROM-OT improved with 42.8 points (95% CI from 40.2 to 45.4). Participants received a median of seven sessions of occupational therapy (IQR 5-10) with a median duration of 18 weeks (IQR 12-25). They valued the contribution of occupational therapy to their improved functioning with a mean score of 8 (SD 1.4) and recommended this to others with a mean score of 9 (SD 1.2).

CONCLUSIONS

Persons with COVID-19 who received occupational therapy in primary care improved significantly in daily functioning and highly valued occupational therapy.