Is a Prescriptive or an Open Referral Related to Physical Therapy Outcomes in Patients With Lumbar Spine-Related Problems?

Brooks, Gary; Dripchak, Shari; Vanbeveren, Patrick; Allaben, Susan

doi:10.2519/jospt.2008.2591

Cited by 9 publications

(5 citation statements)

References 23 publications

(12 reference statements)

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“…Most referrals from specialist physicians (60.8%), however, were in the chronic phase of recovery and would not be expected to achieve similar functional gains. 4,12,33 Referrals from PCPs occupied a middle ground in terms of the distribution of symptom duration as well as functional improvement.…”

Section: Discussionmentioning

confidence: 99%

“…33 Another investigation noted that referral source was not associated with functional outcome; however, there was a trend toward an association between specialist physician and lower number of visits. 3 Patients referred from specialist physicians may have clinical characteristics different from those of patients referred by PCPs; for example, they may be more likely to have chronic LBP or more complicated clinical presentations, or to have failed to respond to treatment by a PCP. By the time a patient with LBP is referred to a physical therapist, she/ he might have been seen by a PCP and perhaps additional specialist physicians, and might also have undergone diagnostic procedures, such as imaging studies.…”

Section: T T Conclusion: After Accounting For Clinicalmentioning

confidence: 99%

See 1 more Smart Citation

Referral Source and Outcomes of Physical Therapy Care in Patients With Low Back Pain

Brooks¹,

Dolphin²,

Vanbeveren³

et al. 2012

J Orthop Sports Phys Ther

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Section: Discussionmentioning

confidence: 99%

Section: T T Conclusion: After Accounting For Clinicalmentioning

confidence: 99%

Referral Source and Outcomes of Physical Therapy Care in Patients With Low Back Pain

Brooks¹,

Dolphin²,

Vanbeveren³

et al. 2012

J Orthop Sports Phys Ther

Self Cite

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“…-better patient outcomes (through earlier access to care) in terms of disability and health-related quality of life [25][26][27][28]; in contrast, reduction in pain appears to be similar between the different models of care [29][30][31][32][33];…”

Section: Direct Access Physiotherapy: a Primary Care Model With Physi...mentioning

confidence: 99%

New models of care integrating more autonomous roles for physiotherapists: a narrative review

Demont¹,

Kechichian²,

Davergne³

et al. 2022

Physiother Quart.

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With the increased prevalence of non-communicable diseases and chronic disorders, including musculoskeletal disorders, access to care is limited in many health care systems and new multidisciplinary collaborative models of care have now been implemented in several countries in an effort to improve access to care. The paper aimed to describe the characteristics and present relevant evidence supporting different models of care that integrate physiotherapists as primary or secondary care practitioners for the management of patients with non-communicable diseases or chronic disorders. on the basis of a literature review up to August 2020 in 4 major bibliographical databases, we searched for studies of any design, including systematic reviews with or without meta-analysis and position statements, that were related to direct access physiotherapy and advanced practice physiotherapy models of care. The impact of direct access physiotherapy and advanced practice physiotherapy models of care is presented in terms of clinical outcomes, patient satisfaction, health care resource use and costs. These models appear to provide equal or better outcomes in terms of access to care, quality of care, and patients' satisfaction. The strength of the evidence is variable, and outcomes vary depending on clinical settings, roles of physiotherapists, and characteristics of patients. This review highlights that these enhanced roles for physiotherapists, such as diagnosing, ordering diagnostic tests, or referring patients to physicians, in both primary and secondary care settings, are beneficial and may help optimize patients' journey by providing earlier access to effective and efficient services compared with physician-led usual care models.

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“…However, cost reduction may be restricted to direct costs and general workload for the Physical Therapist (PT) may not necessarily be reduced ( 11 ). Also, potential disadvantages to this model of health care have been described, for instance, potential erosion of a strong patient-doctor relationship ( 12 , 13 ) or a robust physiotherapy-doctor connection ( 13 ), as well as concerns about overconsumption of physiotherapy services ( 14 ).…”

Section: Introductionmentioning

confidence: 99%

Impact of direct access on the quality of primary care musculoskeletal physiotherapy: a scoping review from a patient, provider, and societal perspective

Cattrysse,

Van Den Broeck,

Petroons

et al. 2024

Arch. Physioter

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Introduction: Worldwide many countries provide direct access in physiotherapy. The aim of this scoping review was to synthesize the available evidence on the quality of primary care musculoskeletal physiotherapy from different perspectives. Methods: Systematic searches were conducted in three databases up to September 2022. Studies were included when regarding assessment of at least one of the following perspectives: patient (quality of Life, patient satisfaction, pain, functioning, adverse events), provider (treatment compliance, responsibility, liability, status, prestige, job satisfaction), and society (number of referrals, amount of medical imaging, medication use, number of sessions needed for rehabilitation, and overall costs and cost-effectiveness). Selection and methodological quality assessment of systematic reviews were performed. Data extraction and analysis were performed separately for systematic reviews and individual primary studies. Results: Five systematic reviews as well as 17 primary studies were included. From a patient perspective, no significant effect of direct access was found for pain and a tendency in favour of direct access was found for quality of life, functioning, and well-being. Concerning providers, higher treatment compliance was found in direct access to physiotherapy and decision-making was more accurate. From a societal perspective, significant differences in favour of direct access physiotherapy were found for waiting time, prescribed medication, and medical imaging. In addition, there was a tendency towards lower health care costs.

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Is a Prescriptive or an Open Referral Related to Physical Therapy Outcomes in Patients With Lumbar Spine-Related Problems?

Cited by 9 publications

References 23 publications

Referral Source and Outcomes of Physical Therapy Care in Patients With Low Back Pain

Referral Source and Outcomes of Physical Therapy Care in Patients With Low Back Pain

New models of care integrating more autonomous roles for physiotherapists: a narrative review

Impact of direct access on the quality of primary care musculoskeletal physiotherapy: a scoping review from a patient, provider, and societal perspective

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