The role of physiotherapy in the treatment of HIV-related sensory neuropathy: The perceptions and referral practices of physicians

Abstract

BackgroundHIV-related peripheral neuropathies are among the most prevalent chronic neurological disorders affecting persons living with HIV and AIDS. In order to improve the physical function and quality of life of those affected by the disease, a holistic or multidisciplinary approach, including physiotherapy, has been suggested for the management of neuropathic pain.AimThe aim of this study was to explore the physicians’ perceptions regarding the role of physiotherapy in the management of patients with HIV-sensory neuropathy (HIV-SN) and their referral practices in Tanzania.MethodsA qualitative study design incorporating purposive sampling was employed in the study. A total of 10 physicians from a hospital in Tanzania agreed to participate in in-depth interviews.ResultsPhysicians had poor perceptions of the role of physiotherapy in the management of patients with HIV-SN. Their inadequate knowledge of the role of physiotherapy and the limited number of physiotherapists employed negatively influenced their referral of patients with HIV-SN for physiotherapy.ConclusionIn Tanzania, referral for physiotherapy is still dependent on medical doctors. Inter-professional learning is imperative for minimising the stereotypes that may exist across professions, hence the need to improve awareness of specific roles in patient management. This could improve knowledge of the role of other professionals in the management and rehabilitation of affected patients and consequently improve perceptions and facilitate referrals of patients with HIV-SN for more integrated care.

Awareness and utilization of physiotherapy services in management of people living with HIV among health care workers

“…14 The findings of this present study may be the major barriers to utilization of physiotherapy services because if physiotherapists had good knowledge in HIV condition and management as reported in other studies, then they would have been prompted to engage in sensitization programs and awareness creation among the HCP and PLWHA which would subsequently boost utilization levels. 15 By so doing, barriers like poor physiotherapist-HCP communication with regards to HIV management, poor recommendation/ referral to physiotherapy services by HCP, poor awareness creation by physiotherapists as identified in this study, would have been counteracted/neutralized. Although, a study identified poor perception of physicians in Tanzania on the role of physiotherapy in HIV associated sensory neuropathy as a barrier to utilization of physiotherapy.…”

“…This is in agreement with the findings of so many studies regarding the perception of healthcare providers on role of physiotherapy in HIV condition and management. 12,15 Also, the remaining few who were aware of possible roles of physiotherapy obtained this information mainly from doctors and other sources not necessarily physiotherapist (Table 2). This implies that physiotherapist may not have created awareness on their specific role in HIV management or there is poor interdisciplinary team work in HIV management.…”

“…In Nigeria, majority of HIV based studies focused on the effects of physiotherapy intervention in ameliorating HIV/HAART complications with paucity of studies investigating factors limiting the awareness and utilization of physiotherapy intervention among PLWHA. 14,15 Moreover, studies have reported deficits in physician's awareness on the role of physiotherapy in HIV management. 16 In Nigeria, the physicians refer while healthcare providers can recommend patient for physiotherapy services, but referral of patients for physiotherapy depends on the perceptions and the awareness of the referring or recommending personnel/parties on the role of physiotherapy in the patient's management.…”