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Abstract Background Country by country similarities and differences in physical therapy practice exists. Therefore, before updates in practice can be provided, such as trainings in evidence-based practice, it is necessary to identify the profile and nature of practice in a given country or setting. Following a search of the international literature, no appropriate tool was identified to collect and establish data to create the profile of physical therapy practice in the Philippines. We therefore developed, validated and pilot tested a survey instrument which would comprehensively describe the practice of physical therapy in the Philippines Findings We used a mixed methods design to answer our study aims. A focus group interview was conducted among a group of physical therapists to establish the content and contexts of items to be included in the survey instrument. Findings were amalgamated with the information from the literature on developing survey instruments/questionnaires. A survey instrument was drafted and named as the Physical Therapy Profile Questionnaire (PTPQ). The PTPQ was then validated and pilot tested to a different group of physical therapists. The final version consisted of five separate parts namely (A) General information and demographics, (B) Practice Profile, (C) Treatment Preferences, (D) Bases for clinical work and (E) Bases for educational/research work. At present the PTPQ is relevant to the Philippines and could be used by any country which has a similar nature of practice with the Philippines. Conclusion The Physical Therapy Practice Questionnaire (PTPQ) was shown to have good face and content validity among the Filipino physical therapists and their context of practice. It has also been found to be useful, easy to administer tool and in a format appealing to respondents. The PTPQ is expected to assist comprehensive data collection to create a profile of physical therapy practice in the Philippines.

Astract Background Evidence implementation continues to challenge health professionals most especially those from developing countries. Filipino physiotherapists represent a group of health professionals in a developing country who by tradition and historical practice, take direction from a doctor, on treatment options. Lack of autonomy in decision-making challenges their capacity to deliver evidence-based care. However, this scenario should not limit them from updating and up-skilling themselves on evidence- based practice (EBP). EBP training tailored to their needs and practice was developed to address this gap. This study will be conducted to assess the effectiveness of a tailored EBP-training program for Filipino physiotherapists, in improving knowledge, skills, attitudes and behaviour to EBP. Participation in this program aims to improve capacity to EBP and engage with referring doctors to determine the most effective treatments for their patients. Methods/Design A double blind randomised controlled trial, assessing the effectiveness of the EBP training intervention, compared with a waitlist control, will be conducted. An adequately powered sample of 54 physiotherapists from the Philippines will be recruited and randomly allocated to EBP intervention or waitlist control. Intervention: The EBP program for Filipino physiotherapists is a one-day program on EBP principles and techniques, delivered using effective adult education strategies. It consists of lectures and practical workshops. A novel component in this program is the specially-developed recommendation form, which participants can use after completing their training, to assist them to negotiate with referring doctors regarding evidence-based treatment choices for their patients. Pre and post measures of EBP knowledge, skills and attitudes will be assessed in both groups using the Adapted Fresno Test and the Questions to EBP attitudes. Behaviour to EBP will be measured using activity diaries for a period of three months. Discussion Should the EBP-training program be found to be effective in improving EBP-uptake in Filipino physiotherapists, it will form the basis of a much needed national intervention which is contextually appropriate to Filipino physiotherapists. It will therefore form the genesis for a model for building EBP capacity of other health professionals in the Philippines as well as physiotherapists in developing countries. Trial Registration Current Controlled Trials: ISRCTN74485061

Purpose: Nasopharyngeal carcinoma (NPC) is a central tumor with a rich lymphatic network and a propensity for bilateral cervical lymph node metastasis. There is an orderly pattern of lymph node involvement in NPC. There is no current standard for prophylactic neck irradiation in node-negative or limited retropharyngeal (RP) node–positive NPC. This study aims to synthesize the current evidence on upper neck irradiation (UNI) versus whole neck irradiation (WNI) as prophylactic neck irradiation in node-negative or limited RP node–positive NPC. Materials and Methods: A search of relevant articles was done from 2000 to October 2015. Critical appraisal and meta-analysis of the eligible studies were undertaken to assess the effectiveness of UNI versus WNI as prophylactic neck irradiation in node-negative or limited involved RP node NPC. Results: Only one randomized controlled trial investigated the use of prophylactic UNI versus WNI and showed no confirmed nodal relapse in both arms. Pooled analysis of four retrospective studies showed no significant difference in nodal recurrence, whether in-field or out-of-field recurrence. There was also no significant difference in terms of 5-year distant metastasis–free and overall survival. Conclusion: In node-negative or limited RP node–positive NPC, the current evidence shows the possibility of treating only the upper neck (levels II, III, and VA) without compromising nodal control, distant metastasis, and overall survival. As a result of the scarcity of data, more randomized clinical trials are warranted in this subset of patients. [ABSTRACT FROM AUTHOR]

Background: Stroke is one of the leading medical conditions in the Philippines. Over 500,000 Filipinos suffer from stroke annually. Provision of evidence-based medical and rehabilitation management for stroke patients has been a challenge due to existing environmental, social, and local health system issues. Thus, existing western guidelines on stroke rehabilitation were contextualized to draft recommendations relevant to the local Philippine setting. Prior to fully implementing the guidelines, an audit of current practice needs to be undertaken, thus the purpose of this audit protocol. Methods: A clinical audit of current practices in stroke rehabilitation in the Philippines will be undertaken. A consensus list of data items to be captured was identified by the audit team during a 2-day meeting in 2012. These items, including patient demographics, type of stroke, time to referral for rehabilitation management, length of hospital stay, and other relevant descriptors of stroke management were included as part of the audit. Hospitals in the Philippines will be recruited to take part in the audit activity. Recruitment will be via the registry of the Philippine Academy of Rehabilitation Medicine, where 90% of physiatrists (medical doctors specialized in rehabilitation medicine) are active members and are affiliated with various hospitals in the Philippines. Data collectors will be identified and trained in the audit process. A pilot audit will be conducted to test the feasibility of the audit protocol, and refinements to the protocol will be undertaken as necessary. The comprehensive audit process will take place for a period of 3 months. Data will be encoded using MS Excel“. Data will be reported as means and percentages as appropriate. Subgroup analysis will be undertaken to look into differences and variability of stroke patient descriptors and rehabilitation activities. Conclusion: This audit study is an ambitious project, but given the "need" to conduct the audit to identify "gaps" in current practice, and the value it can bring to serve as a platform for implementation of evidence-based stroke management in the Philippines to achieve best patient and health outcomes, the audit team is more than ready to take up the challenge. [ABSTRACT FROM AUTHOR]

Evidence-based practice (EBP) is integral in the health care system whether in developed or developing countries. Thus, all health professionals need to be trained in EBP. An EBP training program was conducted to health professionals in a developing country, the Philippines. The health professionals (medical doctors and allied health professionals [physical therapists and occupational therapists]) were working in hospitals in Manila, Philippines. The program aimed to build capacity in EBP in terms of knowledge and skills. The EBP training program was conducted as a 1-day face-to-face training. Pre- and post-test measures of EBP knowledge and skills were taken prior to and immediately after the 1-day training, using the Fresno test of evidence-based medicine for the medical doctors and the Adapted Fresno test for the allied health professionals. The EBP training program resulted in significant improvements in knowledge and skills for both the medical doctors (change in pre- and post-Fresno test measures, 95% confidence interval [CI]: 14.6-23.5; P⩽0.05) and the allied health professionals (change in pre- and post-Adapted Fresno test measures, 95% CI: 32.7-38.5; P⩽0.05). The EBP training conducted amongst the health professionals is an effective and tested undertaking in introducing EBP in developing countries such as the Philippines. [ABSTRACT FROM AUTHOR]

Background & Objectives: Most medical complications following acute stroke are preventable (such as cardiac events, pneumonia, bed sores and venous thrombosis). This was a study on the frequency of medical complications and their association with key performance indicators. Methods: The study used a cross-sectional baseline audit of stroke care practices. The audit captured details on the nature of the stroke, patient demographics, characteristics of hospital care, and compliance with six key quality indicators in Philippine Academy of Rehabilitation Medicine Clinical Practice Guideline on Stroke Rehabilitation. Patient records were retrospectively consecutively sampled. Results: A total of 1,683 patients were included in the audit which came from 49 hospitals. Medical complications were seen in 182 patients (11.2%). Pneumonia contributed to half the medical complications (50%), followed by respiratory failure (7.7%) and gastrointestinal bleeding (3.8%). Presence of medical complications were associated with in-patient mortality (OR 3.3 (95% CI 2.1-5.3)) and prolonged hospital stay (16.1 ± 20.7 days vs 9.6 + 10.9 days). The best predictor model for pneumonia included variables of not having a swallow screen within the first 24 hours, having a nasogastric tube inserted, not achieving medical stability, not having a stroke unit in the admitting hospital, having suffered a previous stroke and being older. Conclusion: Non-adherence to evidence-based stroke care rehabilitation guidelines contributed significantly to medical complications in an audit of Filipino stroke patients. [ABSTRACT FROM AUTHOR]