Quality of Care and Patient-Reported Outcomes in Carpal Tunnel Syndrome

A Prospective Observational Study

Published in: Muscle & Nerve [Epub December 2017]. doi: 10.1002/mus.26041

Posted on RAND.org on February 13, 2018

by Teryl K. Nuckols, Craig Conlon, Michael Robbins, Michael Dworsky, Julie Lai, Carol P. Roth, Barbara Levitan, Seth A. Seabury, Rachana Seelam, Douglas Benner, Steven M. Asch

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Introduction

Higher quality care for carpal tunnel syndrome (CTS) may be associated with better outcomes.

Methods

This prospective observational study recruited adults diagnosed with CTS from 30 occupational health centers, evaluated physicians' adherence to recommended care processes, and assessed results of the Boston Carpal Tunnel Questionnaire (BCTQ) and Short Form Health Survey version 2 (SF-12v2) at recruitment and at 18 months.

Results

Among 343 individuals, receiving better care (80th vs. 20th percentile for adherence) was associated with greater improvements in BCTQ Symptom Severity scores (-0.18, 95% confidence interval [CI] -0.32 to -0.05), BCTQ Functional Status scores (-0.21, 95% CI -0.34 to -0.08), and SF12-v2 Physical Component scores (1.75, 95% CI 0.33-3.16). Symptoms improved more when physicians assessed and managed activity, patients underwent necessary surgery, and employers adjusted job tasks.

Discussion

Efforts should be made to ensure that patients with CTS receive essential care processes including necessary surgery and activity assessment and management.

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