Osteopathic COVID 19 care project

On this page you will find information about:

General research about COVID-19

Osteopathic COVID-19 project

  • Aims and reason for the project
  • Case study report writing
  • Collecting patient reported outcomes

Research about COVID-19

 

Links to useful sites

UK Government. https://www.gov.uk/coronavirus

General Osteopathic Council. https://www.osteopathy.org.uk/standards/guidance-for-osteopaths/coronavirus-covid-19/

Institute of Osteopathy. https://www.iosteopathy.org/covid-19/

British Medical Journal. https://www.bmj.com/coronavirus

The Lancet. https://www.thelancet.com/coronavirus

Centre for Disease Control USA. https://www.cdc.gov/

World Health Organisation. https://www.who.int/emergencies/diseases/novel-coronavirus-2019

European Centre for Disease Prevention. https://www.ecdc.europa.eu/en/covid-19-pandemic

 

Osteopathic COVID-19 project

The aim of the Osteopathic COVID-19 project is to collect data about osteopathic care and how patients presenting with long CoViD symptoms respond to osteopathic care. This will help us to understand how to optimise the management of Long Covid with other support available for better patient care.

Long COVID-19 presents as any signs and symptoms that develop during or after an infection consistent with COVID-19, that continue for more than 12 weeks and are not explained by an alternative diagnosis.

The project has 2 elements:

1. Long COVID-19 osteopathic patient care and management

We would like to collect examples of cases where patients have presented with Long COVID-19 symptoms to understand the patients’ problems and to describe the osteopathic approach to care.

We are asking osteopaths to write up case studies about the care they give to patients with Long COVID-19. We aim to collate these reports and analyse the content of the studies based on:

  • Patient characteristics
  • Patient presenting symptoms/complaints (physical, psychological and social)
  • The osteopathic approach to the consultation
  • The actual physical treatment given
  • The advice/guidance given to patients
  • The ongoing management and support offered
  • The nature of any referral made
  • The follow up progress and adaptations made to care and treatment over time

We provide a template which you can use to describe your patient and your care. Please complete it as comprehensively as possible and return to c.fawkes@qmul.ac.uk. No information that could identify the patient should be included in the template.

We also provide a checklist about things to consider when writing a case report below.

The best way to write a case report is from the first contact with the patient who fulfils your criteria of interest in this case:

A person who presents with any signs and symptoms that have developed during or after an infection consistent with COVID-19, that continue for more than 12 weeks and are not explained by an alternative diagnosis.

You will be able to use your normal case notes to write up your study but in addition it is worth having some formal follow up questions that you ask at each visit and to ask the patient to complete a questionnaire independent from you so that there is no potential for the patient to give a socially desirable response.

In your face to face or online consultation we would like you to ask the patient at the first consultation:

What are the three most important aspects of your health that you would like to address with regard to your osteopathic care?

Make a note of these and then ask:

On a scale of 0 – 10 where 10 is the worst possible scenario and 0 is no problem where would you describe yourself along this continuum?

Please record this information.

Please ask the same question at each consultation using the same areas of concern as described in the first consultation.

You can also ask the patient to describe any unwanted or unexpected reactions experienced after the consultation. You will need this to write up your case study.

Before you write up and send the case study to us please seek and document the patient’s consent to do so for your own records, but please ensure that there is no patient identifiable information in the case study.

No names should be mentioned, no location and no age (just the age in a decade range). You, as the osteopath, should not be identifiable in the transcript as well.

Information about writing case reports can be found on the The CARE guidelines (for CAse REports) website at https://www.care-statement.org/ A checklist for writing case reports can be found at https://www.care-statement.org/checklist

The International Journal of Osteopathic Medicine which you can access via your GOsC O-zone account has a very good article outlining how to write a good case study.

Vaughan B, Fleischmann M. A guide to writing a case report of an osteopathic patient. International Journal of Osteopathic Medicine. 2020 (Sept) 37: 34-39 DOI: https://doi.org/10.1016/j.ijosm.2020.05.005

Template (Using the CARE checklist)

You can download a Word document of this template for your own use.

Your case report should have the following sub headings, as a minimum:

  • Title
  • Abstract – (structured or unstructured)
    • Introduction – What is unique about this case and what does it add to the scientific literature?
    • The patient’s main concerns and important clinical findings.
    • The primary diagnoses, interventions, and outcomes.
    • Conclusion – What are one or more “take-away” lessons from this case report?
  • Introduction – Briefly summarizes why this case is unique and may include medical literature references.
  • Patient Information
    • De-identified patient specific information.
    • Primary concerns and symptoms of the patient.
    • Medical, family, and psychosocial history including relevant genetic information.
    • Relevant past interventions and their outcomes.
  • Clinical Findings – Describe significant physical examination (PE) and important clinical findings.
  • Timeline – Historical and current information from this episode of care organized as a timeline (figure or table).
  • Diagnostic Assessment
    • Diagnostic methods (PE, laboratory testing, imaging, surveys).
    • Diagnostic challenges.
    • Diagnosis (including other diagnoses considered).
    • Prognostic characteristics when applicable.
  • Therapeutic Intervention
    • Types of therapeutic intervention (pharmacologic, surgical, preventive).
    • Administration of therapeutic intervention (dosage, strength, duration).
    • Changes in therapeutic interventions with explanations.
  • Follow-up and Outcomes
    • Clinician- and patient-assessed outcomes if available.
    • Important follow-up diagnostic and other test results.
    • Intervention adherence and tolerability. (How was this assessed?)
    • Adverse and unanticipated events.
  • Discussion
    • Strengths and limitations in your approach to this case.
    • Discussion of the relevant medical literature.
    • The rationale for your conclusions.
    • The primary “take-away” lessons from this case report (without references) in a one paragraph conclusion.
  • Patient Perspective – The patient should share their perspective on the treatment(s) they received.
  • Informed Consent – The patient should give informed consent. (Provide if requested.)

 

2. Outcomes of care in patients with Long COVID-19

To report on the outcomes of care that patients with Long Covid experience by collecting data about how they feel after their treatment.

We would like osteopaths to recruit patients with Long COVID-19 to join NCOR’s Patient Reported Outcome Study. In this study we ask osteopaths to give their patients a unique code to register their response to osteopathic care. This is done using an online or phone app questionnaire. There is a specific question asking if the patient has had COVID-19 and whether the reason for their osteopathic visit is as a result of having the virus.

We are hoping to enrol enough patients with Long COVID-19 to be able to do a sub analysis of outcome data specifically for this group of patients.

You can find details about the Patient Reported Outcome Measures Study (or PROMS) here: https://www.ncor.org.uk/practitioners/patient-reported-outcomes/prom-app-collecting-prom-data-in-practice/