Rob W Goodwin1, Paul A Hendrick2. 1. 1Musculoskeletal Clinics Team,Nottingham City Care,Nottingham,UK. 2. 2School of Health Sciences,University of Nottingham,Nottingham,UK.
Abstract
UNLABELLED: Aim To evaluate the clinical effectiveness, patient satisfaction and economic efficacy of a physiotherapy service providing musculoskeletal care, as an alternative to GP care. BACKGROUND: There is a growing demand on general practice resources. A novel '1st Line Physiotherapy Service' was evaluated in two GP practices (inner city practice, university practice). Physiotherapy, as a first point of contact, was provided as an alternative to GP care for patients with musculoskeletal complaints. Participants A convenience cohort sample of over 500 patients with a musculoskeletal complaint was assessed within the physiotherapy service. For the economic evaluation a cohort of 100 GP patients was retrospectively reviewed. METHOD: Clinical outcome measures were collected at assessment, one and six months following assessment. Patient satisfaction was collected at assessment. An economic evaluation was undertaken on the physiotherapy cohort of patients and compared to a retrospective cohort of patients (n=100) seen by a GP. This evaluation considered only the health care perspective (primary and secondary care). Societal issues such as absence from employment were not considered. RESULTS: There were no adverse events associated with the physiotherapy service. Patients reported high levels of satisfaction with the physiotherapy service. Patients managed within the 1st Line Physiotherapy Service demonstrated clinical improvements (EQ-5D-5L, Global Rating of Change) at the six-month point. There was a statistically significant difference in favour of the physiotherapy groups using a non-parametric bootstrap test; inner city practice, mean difference in costs=£538.01 (P =0.006; 95% CI; £865.678, £226.98), university practice mean difference in costs=£295.83 (P=0.044; 95% CI; £585.16, £83.69). CONCLUSION: The limitations of this pragmatic service evaluation are acknowledged. Nevertheless, the physiotherapy service appears to provide a safe and efficacious service. The service is well received by patients. There appear to be potential financial implications to the health economy. Physiotherapists, as a first point of contact for patients with musculoskeletal-related complaints, could contribute to the current challenges faced in primary care.
UNLABELLED: Aim To evaluate the clinical effectiveness, patient satisfaction and economic efficacy of a physiotherapy service providing musculoskeletal care, as an alternative to GP care. BACKGROUND: There is a growing demand on general practice resources. A novel '1st Line Physiotherapy Service' was evaluated in two GP practices (inner city practice, university practice). Physiotherapy, as a first point of contact, was provided as an alternative to GP care for patients with musculoskeletal complaints. Participants A convenience cohort sample of over 500 patients with a musculoskeletal complaint was assessed within the physiotherapy service. For the economic evaluation a cohort of 100 GP patients was retrospectively reviewed. METHOD: Clinical outcome measures were collected at assessment, one and six months following assessment. Patient satisfaction was collected at assessment. An economic evaluation was undertaken on the physiotherapy cohort of patients and compared to a retrospective cohort of patients (n=100) seen by a GP. This evaluation considered only the health care perspective (primary and secondary care). Societal issues such as absence from employment were not considered. RESULTS: There were no adverse events associated with the physiotherapy service. Patients reported high levels of satisfaction with the physiotherapy service. Patients managed within the 1st Line Physiotherapy Service demonstrated clinical improvements (EQ-5D-5L, Global Rating of Change) at the six-month point. There was a statistically significant difference in favour of the physiotherapy groups using a non-parametric bootstrap test; inner city practice, mean difference in costs=£538.01 (P =0.006; 95% CI; £865.678, £226.98), university practice mean difference in costs=£295.83 (P=0.044; 95% CI; £585.16, £83.69). CONCLUSION: The limitations of this pragmatic service evaluation are acknowledged. Nevertheless, the physiotherapy service appears to provide a safe and efficacious service. The service is well received by patients. There appear to be potential financial implications to the health economy. Physiotherapists, as a first point of contact for patients with musculoskeletal-related complaints, could contribute to the current challenges faced in primary care.
Authors: Kyle Vader; Rachelle Ashcroft; Brenna Bath; Simon Décary; Simon Deslauriers; François Desmeules; Catherine Donnelly; Kadija Perreault; Julie Richardson; Sarah Wojkowski; Jordan Miller Journal: Physiother Can Date: 2021-02-23 Impact factor: 1.037
Authors: Lisa Pagano; Zoe McKeough; Sally Wootton; Stephen Crone; Deborah Pallavicini; Andrew S L Chan; Sriram Mahadev; Nicholas Zwar; Sarah Dennis Journal: Pilot Feasibility Stud Date: 2020-09-23
Authors: Karin Schröder; Birgitta Öberg; Paul Enthoven; Alice Kongsted; Allan Abbott Journal: BMC Health Serv Res Date: 2020-05-19 Impact factor: 2.655
Authors: Rob Goodwin; Fiona Moffatt; Paul Hendrick; Stephen Timmons; Neil Chadborn; Pip Logan Journal: Physiotherapy Date: 2020-02-19 Impact factor: 3.358
Authors: Karin Schröder; Birgitta Öberg; Paul Enthoven; Henrik Hedevik; Maria Fors; Allan Abbott Journal: J Clin Med Date: 2021-03-16 Impact factor: 4.241