Re-imagining the role of the physiotherapist when managing people with long-term conditions

Abstract

The rising prevalence of long-term conditions (LTCs) is placing increasing pressures on healthcare systems. With the future prospect that more individuals will experience multiple comorbidities, LTCs are becoming a growing concern. This article aims to discuss the challenges faced by and the opportunities afforded to physiotherapists when caring for people with LTCs. It highlights the complexity of managing people with LTCs and the demands faced by physiotherapists when working within a transitioning healthcare service that necessitates cost-effective yet, sustainable care. It considers ways that interventions can be optimized to not only support individuals with LTCs to improve their quality of life, but live an existence that has meaning and purpose. It also explores health promotion strategies that could be influential in changing the future healthcare landscape, by helping to prevent the occurrence of LTCs. The wider intention is to facilitate discussion of the future role of the physiotherapy profession in LTC management, in the hope that a shared vision can be created that is inspiring and transformative. A vision that imagines a physiotherapy service that is resilient to change and contemporary in approach, which continues to evolve to support the changing needs of people with LTCs.

Evidence-Based Practice for Non-Specific Low Back Pain: Canadian Physiotherapists’ Adherence, Beliefs, and Perspectives

“…This depicts an image of outdated physiotherapy care wherein non-physical issues are not worthy of attention, which goes against the biopsychosocial model of care for NSLBP. Although not trained to intervene in psychological disorders or social issues, physiotherapists as primary care providers might be the only health care professional with enough direct and continuous patient contact hours to be able to identify potential issues that may interfere with recovery and guide patients towards appropriate management (Guilcher, 2018;Hartley, 2018). The role of the physiotherapy profession has evolved and continues to do so as health services change towards a holistic and patient-centred approach for the non-surgical management of long-term conditions such as NSLBP (Hartley, 2018).…”

“…Although not trained to intervene in psychological disorders or social issues, physiotherapists as primary care providers might be the only health care professional with enough direct and continuous patient contact hours to be able to identify potential issues that may interfere with recovery and guide patients towards appropriate management (Guilcher, 2018;Hartley, 2018). The role of the physiotherapy profession has evolved and continues to do so as health services change towards a holistic and patient-centred approach for the non-surgical management of long-term conditions such as NSLBP (Hartley, 2018). Therefore, physiotherapists should be intimately familiar with knowledge tools such as EBCPGs to remain up to date with evidence and be open to expanding their skill set to be able to provide the highest quality care for NSLBP patients.…”

Person-centred integrated care with a health promotion/public health approach: a rapid review

“…Parallel to the momentum of both person-centred care and integrated care is the advocation of a public health approach to protect and promote the health and wellbeing of communities and populations; a dominant feature of both UK and global policy (Public Health England, 2016; WHO, 2013). This shift of service delivery emphasis to health promotion and improvement is evident in the development and proposal of new models of care (Lee et al , 2018; Hartley, 2019). However, despite the importance of both health promotion/public health approaches and person-centred integrated care nationally and globally, the possibilities of combining these and the relationship to health and wellbeing outcomes is not yet fully explored.…”

Development and Reliability of the Physical Therapy Healthy Lifestyle Appraisal: A New Assessment Tool to Guide Behavior Change

“…In the US, public health professionals and health care providers have been encouraged to participate in these important initiatives and engage in these conversations with their patients. 2-9 Physical therapists (PTs) have identified a number of challenges and barriers to engaging in health promotion practice with their patients, including compensation, education, training, and time. 10-15…”

“…In the US, public health professionals and health care providers have been encouraged to participate in these important initiatives and engage in these conversations with their patients. [2][3][4][5][6][7][8][9] Physical therapists (PTs) have identified a number of challenges and barriers to engaging in health promotion practice with their patients, including compensation, education, training, and time. [10][11][12][13][14][15] At the Second Physical Therapy Summit on Global Health, a multilevel action plan was developed to identify means to support PTs in integrating health promotion into their practices.…”