Study backs giving physiotherapy by phone

Phone-based physiotherapy services can provide safe and effective care while reducing waiting lists, according to a paper published in the BMJ.

However, it is not necessarily cheaper than standard care, says co-author Nadine Foster, a professor at Keele University.

Researchers studied the use of PhysioDirect, a service run by trained physios that patients can ring for advice or an initial assessment.

The physio may then continue phone support or see the patient if necessary.

The randomised controlled trial covered more than 2,000 patients with musculoskeletal problems, in four parts of England. Two thirds of them used PhysioDirect, while the rest had usual care.

Just over half the PhysioDirect users turned out to need a face-to-face appointment – waiting an average of seven days instead of 34 in usual care.

Natalie Beswetherick, the CSP’s director of practice and development, welcomed the findings.

‘As the study shows, it is essential that any telephone triage system allows for patients to receive hands-on treatment where appropriate,’ she added.

The researchers found PhysioDirect care as effective for patients as usual care, with no adverse effects.

Questioned afterwards, PhysioDirect users were nearly as satisfied as those who had usual care. And they were even more willing than the control group to use the service in the future.

‘We would urge the government to look closely at this study, and other successful examples from around the country, and provide more opportunities for patients to gain faster access to physiotherapy,’ said Mrs Beswetherick.

Professor Foster, who is based at the Arthritis UK primary care centre, was one of the principal investigators in the trial.

‘The important thing to learn from this trial is that you can achieve equivalent patient outcomes in terms of pain and function via PhysioDirect. It gives an option in treatment modules for new services,’ she said.

‘There’s a common assumption that providing care via the telephone might be a cheaper option, but this trial shows very clearly that it’s not as simple as that,’ Professor Foster added.

‘It’s safe and cost-effective, but not necessarily cheaper than face-to-face.’

The PhysioDirect service was provided by musculoskeletal physios on band 6 or above, she said. Usual care could be provided by less experienced physios.

The study can be read at: www.bmj.com/cgi/doi/10.1136/bmj.f43

Author
Janet Wright

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