Barriers to & Facilitators of Integration of OT Into Primary Care: An Exploration of Contemporary Practice in the United States

PURPOSE: To synthesize and report occupational therapists’ current practice in primary care and recommendations for further integration into this setting.

DESIGN: This was a descriptive qualitative design using semi-structured interviews. We used purposive and snowball sampling to recruit licensed occupational therapists with at least 6 months primary care experience in the U.S.

METHOD: Participants completed a brief demographic survey and an interview. We engaged in iterative inductive and deductive coding, data-memoing, and study team discussion to develop initial themes. Member-checking allowed the participants to add context and ensure accuracy of initial themes.

RESULTS: Participants (n=7) included occupational therapists with 1 to 8 years of experience in primary care. Four themes emerged from the data: 1) gaining entry, 2) navigating team-based care, 3) providing patient-centered care, and 4) expanding reach nationally. First, participants described different ways they began working in the primary care setting. Second, participants discussed the importance of building relationships with team members and understanding team roles, including clarifying the role of occupational therapy. Third, participants discussed filling gaps in care for patients with unmet chronic care needs, and fourth, they described actions needed to secure occupational therapy’s position in primary care.

CONCLUSIONS: Occupational therapists who are working in primary care settings in the U.S. helped focus the discussion of the present role and provide a roadmap for further integration into the primary care setting.

IMPACT STATEMENT: Given the evidence supporting the role of occupational therapy as part of the interprofessional primary care team and the timeliness of this study of contemporary practice, it is imperative that clinicians, researchers, and future practitioners progress occupational therapy’s position as primary healthcare providers.

References

Halle, A. D., Mroz, T. M., Fogelberg, D. J., & Leland, N. E. (2018). Occupational therapy and primary care: Updates and trends. American Journal of Occupational Therapy, 72, 7203090010. https://doi.org/10.5014/ajot.2018.723001

Koverman, B., Royeen, L., & Stoykov, M. (2017). Occupational therapy in primary care: Structures and processes that support integration. Open Journal of Occupational Therapy, 5, 12. https://doi.org/10.15453/2168-6408.1376