Physiotherapy triage assessment of patients referred for orthopaedic consultation – Long-term follow-up of health-related quality of life, pain-related disability and sick leave

Samsson, Karin; Larsson, Maria

doi:10.1016/j.math.2014.06.009

Cited by 28 publications

(52 citation statements)

References 41 publications

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“…A recent Swedish randomised controlled trial comparing physiotherapist-led orthopaedic triage with standard practice (i.e. referral straight from the general practitioner to the orthopaedic surgeon), showed significantly better selection accuracy for orthopaedic intervention and to shorter waiting times [ 6 ], good perceived quality of care [ 7 ] and no difference regarding long term follow up of patient-reported outcomes [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

“Take me seriously and do something!” - a qualitative study exploring patients’ perceptions and expectations of an upcoming orthopaedic consultation

Samsson

Bernhardsson

Larsson

2017

BMC Musculoskelet Disord

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BackgroundPatients’ perceptions of care is an important factor in evaluation of health care, in quality assessment, and in improvement efforts. Expectations of assessments or procedures such as surgery have been found to be related to perceptions of outcome as well as satisfaction, and are therefore of interest to both clinicians and researchers. Increased understanding of these patient views is important so that orthopaedic assessments, regardless of who performs them, can be further developed and patient-centred to better meet patients’ needs. The purpose of this study was therefore to explore patients’ perceptions and expectations of an upcoming orthopaedic consultation.MethodsThis was an explorative qualitative study with an inductive approach. Thirteen patients who were referred for orthopaedic consultation were included using a purposeful sampling strategy. Patients participated in individual, semi-structured interviews that were recorded, transcribed verbatim and analysed with qualitative content analysis.ResultsThe participants’ expressed perceptions and expectations of the upcoming orthopaedic surgeon consultation were classified into 5 categories: Hoping for action, Meeting an expert, A respectful meeting, Participating in the consultation, and A belief that hard facts make evidence. Across the categories, an overarching theme was formulated: Take me seriously and do something! The participants emphasised a desire to be taken seriously and for something to happen, both during the consultation itself and as a result of the orthopaedic consultation. They described a trust in the expertise of the orthopaedic surgeon and stressed the importance of the surgeon’s attitude, but still expected to participate in the consultation as well as in the decision-making process.ConclusionsThe study findings illuminate aspects that are important for patients in an orthopaedic consultation. The descriptions of patients’ perceptions and expectations can serve to improve patient–clinician relationships as well as to inform the development of new models of care, and a greater understanding of these aspects may improve the patient experience.

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Section: Introductionmentioning

confidence: 99%

“Take me seriously and do something!” - a qualitative study exploring patients’ perceptions and expectations of an upcoming orthopaedic consultation

Samsson

Bernhardsson

Larsson

2017

BMC Musculoskelet Disord

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“…The study showed significantly better selection accuracy and shorter waiting times with physiotherapist-led triage than with standard practice. Furthermore, the study showed no differences between physiotherapy-led triage and standard practice regarding the secondary outcome long-term follow-up of patient-reported outcome measures [ 21 ]. In this paper, we report on the secondary outcome patients’ perceived quality of care with this model of care.…”

Section: Introductionmentioning

confidence: 99%

Perceived quality of physiotherapist-led orthopaedic triage compared with standard practice in primary care: a randomised controlled trial

Samsson

Bernhardsson

Larsson

2016

BMC Musculoskelet Disord

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BackgroundPhysiotherapist-led orthopaedic triage, where physiotherapists diagnose and determine management plans, aims to enhance effectiveness and provide the best care. However, scientific evidence for the effectiveness of this model of care remains limited, and there are few studies reporting on patients’ perceptions of the care provided. The purpose of this study was to evaluate patients’ perceived quality of care in a physiotherapist-led orthopaedic triage in primary care, compared with standard practice.MethodsIn a randomised controlled trial, patients of working age referred for orthopaedic consultation at a primary healthcare clinic in Sweden received either physiotherapist-led triage (n = 102) or standard practice (orthopaedic surgeon assessment) (n = 101). Neither subjects nor clinicians were blinded.The questionnaire Quality from the Patient's Perspective (QPP) was used to evaluate perceived quality of care focusing on the caregivers’ medical-technical competence and identity-orientated approach. Also, to what extent patients’ expectations were met, and their intention to follow advice was evaluated.ResultsFor this study, 163 patients (80 %) were analysed (physiotherapist-led triage (n = 83), standard practice (n = 80)). Participants perceived significantly higher quality of care with the triage than with the standard practice in regards to receiving best possible examination and treatment (medical-technical competence) (p < 0.001). This was also found in regards to receiving information about examination and treatment (p < 0.001), results (p < 0.001), and self-care (p < 0.001), the caregiver’s understanding (p < 0.001), respect (p < 0.001) and commitment (p < 0.001) as well as the opportunity to participate in decision-making (p = 0.01) (identity-orientated approach). Participants in the physiotherapist-led triage group reported to a significantly higher extent that their expectations of the treatment were met (p < 0.001), as well as the intent to follow the advice and instructions received (p = 0.019).ConclusionsThis paper reports on patients’ perceptions of quality of care in a physiotherapist-led orthopaedic triage compared with standard practice. Patients in both groups reported that they perceived good quality of care, with the patients in the physiotherapist-led triage reporting significantly higher perceived quality of care than those in the standard practice group. This model of care seems to meet patients’ expectations and result in a greater intention to follow advice and instructions for self-management.Our findings are in line with existing literature that this model of care provides an opportunity to shape patient-centered care that can improve access and offer care on the most appropriate level, with maintained good quality of care.Trial registrationClinical Trials NCT02265172. Registered 10 June 2014

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“…Pre-and postassessment Valid and reliable in osteoarthritis of the knee (Beard, Knezevic, Al-Ali, Dawson, & Price, 2010). Valid and responsive in chronic LBP (Soer, Reneman, Speijer, Coppes, & Vroomen, 2012) and chronic pain (Obradovic, Lal, & Liedgens, 2013) (Goodwin & Hendrick, 2016;Ludvigsson & Enthoven, 2012;Marks, Bisset, et al, 2016a;Richardson et al, 2005;Samsson & Larsson, 2015;Sephton et al, 2010) Sf-36 8 subscale scores with overall score range 0-100 (worst to best)…”

Section: Quality Of Lifementioning

confidence: 99%

“…Valid and reliable (Soer et al, 2013;Tait, Chibnall, & Krause, 1990) (Samsson & Larsson, 2015) Health assessment questionnaire (HAQ) 8 subscales score with score averaged to give score range 0-3 (best to worst)…”

Section: Pre-and Postassessmentmentioning

confidence: 99%

Patient‐reported outcome measures in advanced musculoskeletal physiotherapy practice: a systematic review

Fennelly

Blake

Desmeules

et al. 2017

Musculoskeletal Care

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Physiotherapy triage assessment of patients referred for orthopaedic consultation – Long-term follow-up of health-related quality of life, pain-related disability and sick leave

Cited by 28 publications

References 41 publications

“Take me seriously and do something!” - a qualitative study exploring patients’ perceptions and expectations of an upcoming orthopaedic consultation

“Take me seriously and do something!” - a qualitative study exploring patients’ perceptions and expectations of an upcoming orthopaedic consultation

Perceived quality of physiotherapist-led orthopaedic triage compared with standard practice in primary care: a randomised controlled trial

Patient‐reported outcome measures in advanced musculoskeletal physiotherapy practice: a systematic review

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