Patient experiences of referral practices and primary care physiotherapy for chronic nonspecific low back pain

Boyle, Eileen M.; Evans, Kerrie; Coates, S.; Fary, Robyn; Bennell, Kim L; Sterling, Michele; Rebbeck, Trudy; Beales, Darren

doi:10.1080/09593985.2022.2141599

Cited by 4 publications

(11 citation statements)

References 82 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“… 24 , 41–61 , 64 Summary descriptive data are provided in Table 2 (studies of barriers and enablers) and Table 3 (studies of interventions). Of the 23 studies, 14 reported on barriers to and enablers of the implementation of EBP, 24 , 41–48 , 50–53 , 64 and 10 reported on interventions aimed at enhancing the implementation of EBP for chronic pain. 45 , 49 , 54–61 One study reported on both.…”

Section: Resultsmentioning

confidence: 99%

“… 46 Platforms such as social networks and forums to enhance adherence were explored in this study, which for some patients were considered a barrier because of confidentiality concerns. 46 Another study of patients with CLBP 41 reported that fragmented care, including insufficient interprofessional communication, was perceived as a barrier to care. Patients described a lack of formal referral between their general practitioner (GP) and physiotherapist, which for some was only done when prompted by the patient.…”

Section: Resultsmentioning

confidence: 99%

“…Patients described a lack of formal referral between their general practitioner (GP) and physiotherapist, which for some was only done when prompted by the patient. 41 Patients also described feelings of anger when no further options or onward referrals were made available to them if they were unresponsive to treatment. Lastly, patients described lack of trust in their physiotherapist as a barrier to reaching agreement on treatment options.…”

Section: Resultsmentioning

confidence: 99%

“…All of the included qualitative studies 24 , 41–53 and randomized controlled trials 54–61 were independently assessed for risk of bias by authors C.D. and P.R.…”

Section: Methodsmentioning

confidence: 99%

See 3 more Smart Citations

Patient-related barriers and enablers to the implementation of high-value physiotherapy for chronic pain: a systematic review

Dickson,

de Zoete,

Berryman

et al. 2023

Pain Medicine

View full text Add to dashboard Cite

Objective To identify, and synthesize patient-related barriers and/or enablers to the implementation of high-value physiotherapy (HVP) for chronic pain. Further, to review what patient-related interventions have been used to facilitate the implementation of HVP for chronic pain, and their efficacy. Methods We systematically searched APA PsycInfo, Embase, CINAHL, Medline, Scopus, and PEDro databases for peer-reviewed studies (published in English) regarding adults with chronic pain. Identified themes relating to barriers and enablers were synthesized using the Theoretical Domains Framework of behavior change. Outcomes from studies reporting on interventions were also qualitatively synthesized. Results Fourteen studies reported on barriers and enablers, eight related to exercise adherence. Themes common to barriers and enablers included: perceived efficacy of treatment, interrelationship with the physiotherapist, exercise burden, and patient’s understanding of exercise benefits. Other barriers included fear of movement, fragmented care, and cost. Ten studies explored interventions, nine of which aimed to improve exercise adherence. Of these, evidence from four randomized-controlled trials of technology-based interventions demonstrated improved exercise adherence amongst interventions groups compared to controls. Conclusion Patients with chronic pain experience barriers to HVP, including: their beliefs, the nature of their interaction with their physiotherapist, perceived treatment efficacy, and cost. Enablers include: rapport with their physiotherapist, achievable exercises, and seamless cost-effective care. Technology-based interventions have demonstrated effectiveness at increasing exercise adherence. Our findings suggest that interventions seeking to enhance implementation of HVP need to consider the multifactorial barriers experienced by patients with chronic pain.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…All of the included qualitative studies 24 , 41–53 and randomized controlled trials 54–61 were independently assessed for risk of bias by authors C.D. and P.R.…”

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Patient-related barriers and enablers to the implementation of high-value physiotherapy for chronic pain: a systematic review

Dickson,

de Zoete,

Berryman

et al. 2023

Pain Medicine

View full text Add to dashboard Cite

show abstract

“…People with LBP are frequently referred to physiotherapy (Boyle et al., 2022). There, people are assessed and prescribed treatments including exercise, pacing, manual therapy, behaviour modification and are taught self‐management skills (Corp et al., 2021).…”

Section: Introductionmentioning

confidence: 99%

Musculoskeletal physiotherapists' discharge practices for people treated with low back pain: A United Kingdom survey

Smith,

Singh,

Mcnamee

et al. 2023

Musculoskeletal Care

View full text Add to dashboard Cite

BackgroundPersistent low back pain (LBP) is the leading cause of disability, and a major burden on the healthcare system globally. Many people with LBP experience recurrent pain flares and receive repeated appointments and re‐referrals to services such as physiotherapy. However, it is not clear what the criteria are for discharging people with LBP from physiotherapy services. This study aims to describe the current practices for discharging people from physiotherapy for LBP in the United Kingdom (UK).MethodsA cross‐sectional study using an anonymous online national (UK) survey was conducted among qualified physiotherapists who treat people with LBP in UK musculoskeletal out‐patient services.ResultsA total of 104 surveys were completed. The majority of respondents reported using (i) a shared decision‐making (77%) and (ii) person‐physiotherapist goal attainment (74%) approach to discharging people with LBP. Sixty‐three percent of respondents reported using a patient‐initiated follow‐up (PIFU) approach. Only 8% of respondents reported using a graded discharge approach with ‘booster’ appointments. A PIFU or graded discharge approach was considered most pertinent for people at higher risk of a pain flare (97%; 86%) and with low self‐efficacy to self‐manage their LBP.ConclusionsThis UK survey established that discharge practices for people with LBP after physiotherapy vary. Whilst the majority of people are currently discharged with a PIFU appointment, a graded discharge approach may be more beneficial for people who are less likely to initiate a PIFU appointment. Further consideration on the development of such a pathway is now required.

show abstract

Patient acceptance of care of a novel care pathway for those at risk of poor outcomes from musculoskeletal pain: A mixed methods study

Beales,

Boyle,

Fary

et al. 2024

Musculoskeletal Science and Practice

View full text Add to dashboard Cite

Patient experiences of referral practices and primary care physiotherapy for chronic nonspecific low back pain

Cited by 4 publications

References 82 publications

Patient-related barriers and enablers to the implementation of high-value physiotherapy for chronic pain: a systematic review

Patient-related barriers and enablers to the implementation of high-value physiotherapy for chronic pain: a systematic review

Musculoskeletal physiotherapists' discharge practices for people treated with low back pain: A United Kingdom survey

Patient acceptance of care of a novel care pathway for those at risk of poor outcomes from musculoskeletal pain: A mixed methods study

Contact Info

Product

Resources

About