Referral practices of recent graduate and experienced physiotherapists working in Australian primary care for people with musculoskeletal conditions

Barriers and facilitators of integrating physiotherapy into primary health care settings: A systematic scoping review of qualitative research

“…This systematic review included 44 qualitative studies conducted in 14 countries, mostly high-income countries: United Kingdom (27.2 %, n = 12) [ 34 , 36 , 39 , 47 , 49 , 52 , 58 , 62 , [64] , [65] , [66] , [67] ], Sweden (13.6 %, n = 6) [ 38 , 43 , 53 , 54 , 59 , 63 ], Ireland (11.3 %, n = 5) [ 32 , 35 , 40 , 44 , 48 ], Canada (11.3 %, n = 5) [ 7 , 20 , 23 , 37 , 68 ], the Netherlands (9.1 %, n = 4) [ 31 , 42 , 46 , 50 ], Norway (6.8 %, n = 3) [ 33 , 41 , 61 ], South Africa (4.5 %, n = 2) [ 60 , 69 ], Brazil (2.2 %, n = 1) [ 16 ], Chile (2.2 %, n = 1) [ 45 ], Germany (2.2 %, n = 1) [ 56 ], Iran (2.2 %, n = 1) [ 51 ], Spain (2.2 %, n = 1) [ 55 ], Australia (2.2 %, n = 1) [ 70 ], and multiple-countries (2.2 %, n = 1) [ 57 ]. Semi-structured interviews, focus group sessions, or both of them were the common data collection methods, respectively.…”

“…In terms of financing, seven studies [ 7 , 40 , 44 , 48 , 62 , 68 , 70 ] found inadequate funding systems one of the most critical barriers to integrating physiotherapy in primary care settings. Furthermore, participants in some of the included studies mentioned financial hardships [ 31 , 37 , 62 ], inappropriate payment mechanisms [ 7 ], and undesirable financing structures [ 46 , 50 ] as other financial challenges.…”

“…Table 4 demonstrates the suggested facilitators for integrating physiotherapy into PHC. Regarding the stewardship dimension, 1) improving intra- and inter-professional collaborations [ 20 , 31 , 32 , 40 , 41 , 43 , 51 , 61 , 65 , 66 ]; 2) strengthening teamwork [ 32 , 33 , 35 , 37 , 39 , 48 , 51 , [57] , [58] , [59] , [67] , [68] , [69] , [70] ]; 3) effective communication among PHC team members [ 20 , 33 , 34 , 45 , 52 , 57 , 68 , 70 ]; and 4) enhancing patients’ awareness [ 35 , 47 , 49 , 61 , 69 ] were among the most common facilitators provided by the participants in the included studies. , some studies stated that employing effective advocacy strategies [ 20 , 23 , 40 , 45 , 57 , 60 ], gaining political support [ 51 ], and increasing the awareness of policymakers [ 51 , 69 ] were necessary prerequisites for the effective integration of physiotherapy services into .…”

“…Participants in one study [ 51 ] believed that the participation of physiotherapists in relevant policymaking processes should be greater. Identifying and involving community engagement [ 40 , 51 , 60 ], effective communication [ 20 , 33 , 34 , 45 , 52 , 57 , 68 , 70 ], patient-centered planning [ 45 , 53 , 66 , 68 ], strengthening scientific evidence [ 41 , 50 , 51 , 69 ], and involving the private sector [ 65 , 69 ] were other identified solutions regarding the stewardship component.…”

“…Four qualitative studies [ 20 , 51 , 58 , 68 ] also stated solutions related to financing to smooth the integration of physiotherapy services, which included increasing financial resources, developing a package of rehabilitation services including physiotherapy in PHC, considering competitive payment mechanisms to create incentives, and reducing out-of-pocket. Regarding human resources, participants stated that considering a comprehensive training program for physiotherapists [ 32 , 36 , 40 , 54 , 56 , 57 , 60 , [65] , [66] , [67] , 69 ], as well as facilitating their personal and professional development [ 35 , 48 , 51 , 58 , 60 , 67 ], and providing management and mentorship support [ 32 , [35] , [36] , [37] , 57 , 59 , 70 ], can significantly improve their participation and performance in . In addition to increasing the awareness of physiotherapists regarding PHC [ 20 , 57 , 69 ], they need to learn the necessary administrative skills [ 20 , 32 ] and have the ability to work in a flexible manner [ 20 , 32 , 57 ].…”