Musculoskeletal Physiotherapy: What do patients expect from an initial out-patient appointment?

Purpose

Patient expectations influence therapeutic alliance, clinical outcomes, patient satisfaction and healthcare utilisation. Poor understanding of the role of physiotherapy can affect patient outcomes. It is unclear what patients expect from initial musculoskeletal (MSK) physiotherapy appointments or what they think are important aspects of physiotherapy. Exploring these areas may enhance treatment outcomes, patient satisfaction and delivery of person-centred care. The aim of this project was to explore the expectations of patients attending the MSK Outpatient Physiotherapy Department at a central London NHS Foundation Trust.

Primary expectations of physiotherapy were
Treatment (51%)
Education (48%)
and Diagnosis (34%)

Approach

All patients attending initial appointments were invited to complete a questionnaire (available in English, Spanish and Portuguese). They were completed before and after the initial physiotherapy appointment. Responses to questions regarding expectations of initial physiotherapy appointment and which aspects of physiotherapy patients felt were most important were analysed. Data were summarised using descriptive statistics.

Outcomes

Results: 340 questionnaires were collected. Most patients were referred via GP and most common complaints were low back (30%), shoulder (24%) and knee (23%) pain. Primary expectations of physiotherapy were treatment (51%), education (48%) and diagnosis (34%). 18% expected investigation. 10% expected onward referral. 93% of respondents had their expectations met following initial appointment. There were changes in the aspects of physiotherapy most commonly chosen as important by patients after the initial appointment; less patients chose pain relief (43% to 32%) and more patients chose diagnosis (32% to 43%), education (22% to 40%) and physical assessment (36% to 49%) as important parts of physiotherapy after the initial appointment. There were minimal changes in the number of patients choosing treatment, prevention of further injury, investigation or onward referral as the most important parts of physiotherapy.

Conclusion(s): Patients have clear expectations of MSK physiotherapy initial appointments. The majority of patients felt their expectations were met. Following the initial appointment, more patients rated diagnosis, education and physical assessment as important aspects of physiotherapy.

Cost and savings

No further details. 

Implications

Meeting patient expectations has been shown to improve rapport and patient outcome. This project highlights key patient expectations prior to the first appointment. In practice, this emphasises the importance of providing patients with a clear diagnosis and appropriate education and providing treatment in an explicit way. These results also suggest that the patient/physiotherapist encounter can lead to changes in what patients report are important parts of physiotherapy. Further research is needed to examine how and why these changes occur and to harness this influence in practice.

Top three learning points

No further data. 

Funding acknowledgements

Nore to declare.