Perspectives of Private Practice Physical Therapy Health Care Systems Participating in a Pragmatic Clinical Trial: A Qualitative Study

Abstract Importance The pragmatic clinical trial, Fibromyalgia TENS In Physical Therapy Study (FM-TIPS), includes 4 private practice physical therapy (PT) health care systems (HCS). Private practice HCS are the largest employers of physical therapists (43%) in the United States. This novel study shares the perspectives of the 4 private practice PT-HCS in the clinical trial - as most clinical research is completed at academic centers. These results may benefit both clinicians and researchers considering inclusion of physical therapy from non-academic settings in research. Objectives This study shares perspectives and lived-experiences of the 4 private practice PT-HCS in FM-TIPS. Design A generic qualitative study including semi-structured, individual interviews and a focus group discussion. Setting An electronic platform and in-person observations were utilized. Participants The directors of the four private PT-HCS in FM-TIPS participated. Interventions Individual interviews and focus group discussions were recorded electronically. Surveys of clinician characteristics were completed. Main outcome and Measures Transcriptions were reviewed, coded, and analyzed. A priori codes were compared and combined into themes. Analysis of workforce characteristics compared study trained clinicians to national averages from the American Physical Therapy Association (APTA) for an understanding of clinics. Results Four themes emerged: Participation is not a burden; Private practice directors see benefits; Participation brings challenges and new opportunities; Private practice PT-HCS should participate in future research. The secondary analysis demonstrated clinicians had higher rates of professional membership and advanced training. Conclusion With study team support, private practice PT-HCS participation is feasible and successful, provides benefits to the practice and clinicians, and should be considered for future research. Relevance These results are important information for all aspects of the physical therapy community- from clinicians to academic researchers. The viewpoints of these private practice physical therapy clinics differ from previous research experiences. Understanding facilitators and barriers can inform future clinical research.