Background In response to issues with timely access for musculoskeletal physiotherapy, telephone assessment and advice services have been evaluated in primary care settings. It is unclear whether this service model can reduce wait times and non-attendance rates for Emergency Department (ED) physiotherapy, compared to usual care. A secondary aim was to evaluate service user acceptability. Methods This was a single-site cohort study that compares data on non-attendance rates, wait time to rst physiotherapy contact and participant satisfaction between patients that opted for a service based on initial telephone assessment and advice, versus routine face-to-face appointments. 116 patients were referred for ED physiotherapy over the 3-month pilot at the ED and outpatient physiotherapy department, X, Ireland. 91 patients (78%) opted for the telephone assessment and advice service, with 40% (n=36) contacting the service. 25 patients (22%) opted for the face-to-face service. Data on non-attendance rates and wait time was gathered using the hospital data reporting system. Satisfaction data was collected on discharge using a satisfaction survey adapted from the General Practice Assessment Questionnaire. Independent-samples t-test or Mann Whitney U Test was utilised depending on the distribution of the data. For categorical data, Chi-Square tests were performed. A level of signi cance of p ≤ 0.05 was set for this study. Results Those that contacted the telephone assessment and advice service had a signi cantly reduced wait time (median 6 days; 3-8 days) compared to those that opted for usual care (median 35 days; 19-39 days) (p ≤ 0.05). There was no signi cant between-group differences for non-attendance rates or satisfaction. Conclusion Given the faster access to ED physiotherapy, without compromising on service user satisfaction, this telephone assessment and advice service, which can be introduced rapidly, could be helpful in triaging referrals and minimising face-to-face consultations in line with COVID-19 recommendations. However, a large scale study is warranted to con rm these ndings.

Objectives The objective was to evaluate the effects of direct‐access physiotherapy on patients presenting with a musculoskeletal disorder (MSKD) to the emergency department (ED) on clinical outcomes and use of health care resources. Methods We conducted a randomized controlled trial in an academic ED in Québec City, Canada. We included patients aged 18 to 80 years with minor MSKD. The intervention group had direct access to a physiotherapist (PT) in the ED immediately after triage and prior to physician assessment, and the control group received usual care by the emergency physician without PT intervention. The key variables included clinical outcomes (pain, interference of pain on function) and resources use (ED return visit, medications, diagnostic tests, additional consultations). They were analyzed using descriptive statistics and compared between groups using two‐way analyses of variance, log‐linear analysis, and chi‐square tests. Results Seventy‐eight patients suffering from MSKDs were included (40.2 ± 17.6 years old; 44% women). For the primary clinical outcome, participants in the PT group (n = 40) had statistically lower levels of pain and pain interference at 1 and 3 months. In terms of resource use, participants in the PT group returned significantly less often to the ED. At baseline and 1 month, less prescription medication was used, including opioids, but there were no differences at 3 months. Although over‐the‐counter medication was recommended more at baseline in the PT group, there were no differences in use at 1 month, and the PT group had used them less at 3 months. There were no differences between groups at follow‐up for imaging tests, other professionals consulted, and hospitalization rates. Conclusion Patients presenting with a MSKD to the ED with direct access to a PT had better clinical outcomes and used less services and resources than those in the usual care group after ED discharge and up to 3 months after discharge.