The Role of Physiotherapy Extended Scope Practitioners in Musculoskeletal care with Focus on Decision Making and Clinical Outcomes: A Systematic Review of Quantitative and Qualitative Research

Abstract

There is broad support for the physiotherapy ESP role and evidence of favourable outcomes from ESP intervention. Clinical decisions made by ESPs correlate well with those of medical colleagues, although there is a lack of detail explaining the ESP decision-making process itself and the influences and mechanisms by which this occurs. Copyright © 2016 John Wiley & Sons, Ltd.

Advanced musculoskeletal physiotherapy: Barriers and enablers to multi‐site implementation

“…The AMP service model of care has been implemented across a broad range of specialities in public hospitals, with emerging evidence of improved cost efficiency (Comans, Raymer, O'Leary, Smith, & Scuffham, ; PwC, ). Positive effectiveness outcomes included improving access through a reduction in waiting times and improved patient flow (Bird, Thompson, & Williams, ; Razmjou et al, ; Kinsella et al, ; Samsson & Larsson, ; Thompson, Yoward, & Dawson, ), and high levels of patient satisfaction. AMP services are a safe model of care (Morris, Vine, & Grimmer, ; PwC, ; Sutton, Govier, Prince, & Morphett, ).…”

An evaluation of diagnostic agreement rates between advanced practice physiotherapists and paediatric orthopaedic consultants for children with musculoskeletal complaints

“…Advanced practice physiotherapists (APPs) are specialist physiotherapists who assess and diagnose patients, can order and interpret investigations, and formulate management plans independently. These roles, which are most prevalent in musculoskeletal medicine, are embedded in orthopaedic and rheumatology services internationally (Desmeules et al, ; Samsson & Larsson, ; Thompson, Yoward, & Dawson, ; Trøstrup, Juhl, & Mikkelsen, ). As APPs are often responsible for a patient's complete episode of care, it is essential that they demonstrate excellent clinical reasoning and diagnostic skills.…”

Extended Role Practitioners to Improve Access to Rheumatic Care: What is the Evidence in the Classification of Patients with Spondyloarthritis?

“…To date, studies have examined and described the role of ERP in managing patients with inflammatory arthropathies, but have failed to examine agreement between ERP and physicians or the efficiency of these models 12,13 . Studies that compared interobserver agreement between ERP and physicians for musculoskeletal disorders have mostly been conducted in orthopedic settings 8,14 . A recent study examined the ability of ERP in triaging patients with suspected inflammatory arthritis for priority assessment by a rheumatologist and the effect on access to care 15 .…”