Patient Expectations: An analysis of patients returning to musculoskeletal outpatient physiotherapy compared to patients attending for the first time

Purpose

The aim of this study was to explore the differences in expectations of MSK outpatient physiotherapy from patients who have already seen physiotherapy for their current complaint, and how this differs to those who were attending physiotherapy for the first time.

37% of patients
attending physiotherapy for the first time with a new complaint expected a diagnosis.
31% of patients
attending with the same complaint expected referral for investigation.

Approach

Patients attending initial physiotherapy appointments were invited to complete a questionnaire. Questionnaires were completed before and after initial appointments. The results were sub-categorised based on if patients had attended physiotherapy for the same complaint before or not. Responses to questions regarding expectations of physiotherapy and which aspects of physiotherapy patients felt were most important were analysed. Data was summarised using descriptive statistics.

Outcomes

Results: Of the 334 respondents, only 54 had already seen a physiotherapist for this same complaint. Respondents with back pain, multi-joint pain or knee pain where most likely to have already seen a physiotherapist for the same complaint. The results of the pre-appointment questionnaire demonstrate those who had previously experienced physiotherapy for this problem were more likely to expect treatment (56% vs 52%), to learn about their problem (54% vs 37%) and to be referred for further investigations (31% vs 20%). Those who hadn’t had any physiotherapy for this complaint were also more likely to expect a diagnosis (37% vs 21%) compared to those who had seen physiotherapy before. The results of the post-appointment questionnaire demonstrate that respondents, who were attending for the first time, had an increase in perceived importance of information and education (+9%), and a decrease in perceived importance of pain relief (-18%), treatment to improve function (-8%), hands on treatment (-7%) and onward referral for investigations (-5%). Respondents who had already seen physiotherapy reported an increase in perceived importance of physical assessment (+4%), information and education (+3%), treatment to improve function (+5%), and onward referral to another healthcare professional (+6%). These respondents also had a decrease in perceived importance of pain relief (-22%), and prevention of further injury (-10%). Those returning to physiotherapy were more likely to be dissatisfied following their physiotherapy appointment (16%), compared to those attending for the first time (6%). Despite this, in both groups a high percentage felt their expectations of physiotherapy were met (86% vs 90%).

Conclusion(s): Patients returning to physiotherapy for the same complaint may have different expectations compared to those attending for the first time, including an increase in expectation of onward referral. Similarly, they were less likely to expect a diagnosis than those who were attending for the first time. All patients were highly likely to report their expectations were met, however those returning to physiotherapy were more likely to be dissatisfied following their appointment.

Cost and savings

No further information. 

Implications

Musculoskeletal conditions can be chronic or re-occurring and for this reason, many patients can be re-referred to physiotherapy for the same complaint. These results suggest that patients returning to physiotherapy for the same complaint can have different expectations of our services. It is important that clinicians have an awareness of this and explore these expectations, as meeting patient expectations is linked with improved rapport, patient satisfaction and clinical outcome.

Top three learning points

No further information. 

Funding acknowledgements

None to declare.