Occupational therapy in children: Literature review on indications, utilisation and recommendations

Research area: Rehabilitation and occupational therapy

Duration: April 2013 – October 2013
Publication: LBI-HTA Project report No. 70: https://eprints.aihta.at/1016/

Language: German

Background:
Within health care in Austria occupational therapy (OT) is equated with medical treatment
by § 135 of the General Law on Social Security (1). Patients are referred to OT  by medical doctors. OT is mainly provided by occupational therapists who do not have a contract with the health insurance fund. OT is used in "limitations of psychological, cognitive, creative or communicative life skills in patients of all ages" aiming to allow "independence and ability to act in everyday life" (2).
In several earlier LBI-HTA projects, the status quo of OT in Austria has been described, as well as the evidence of OT (in adults) for treatment in patients with rheumatoid arthritis, stroke, dementia and depression has been explored (3).
Findings of the AOK report on remedies show, that children and young people up to 14 years (in Germany) make up 46.5% of OTs’ patients. 86% of the prescribed services focused on the current indication "CNS disorders and / or developmental disabilities” under the age of 18, another 10% for the indication of "developmental disorder" (4). Corresponding data for the use or indication of these areas is currently unavailable in Austria.

Aim of project:
This project aims to prepare information on the use and on respective indications of OT for children (outside of acute care or rehabilitation) from various sources. Moreover a decision support for the Main Association of Austrian Social Security Institutions should be provided, for which indications subsequent, in-depth assessments on OT for children should be performed.

Research objectives:
• Based on which indications OT in children is prescribed?
• Which recommendations for the prescription of OT in children exist?
• How often are OT services for children provided in different therapeutic areas?

Methods:
• Literature search (unsystematic, web-based) for German financial reports, German service catalogs, etc. (possibly also from other countries with a comparable healthcare system) in order to derive indications and  utilisation data
• Contacting the Austrian and German occupational therapists Association (possibly conducting interviews)
• (systematic) literature search for recommendations (guidelines) for OT in children

Time schedule / milestones:
April 2013: project protocol
May 2013: systematic literature search, non-systematic hand search, literature selection
June – September 2013: data extraction, drafting of report
October 2013: internal and external review, publication

References:
(1) Scheepers C, Steding-Albrecht U, Jehn P, (Hrsg.). Ergotherapie. Vom Behandeln zum Handeln. Lehrbuch für Ausbildung und Praxis. Stuttgart: Thieme Verlag 2011.
(2) Pschyrembel. Klinisches Wörterbuch. Berlin: de Gruyter 2012.
(3) LBI-HTA reports no. 56 - 60, available at
https://eprints.aihta.at/view/types/hta_report.html
(4) Heilmittelbericht der AOK, available at
http://www.wido.de/fileadmin/wido/downloads.pdf