Shorter waiting time, lower rate of nonattendance, but slightly lower satisfaction at six months

WEDNESDAY, Jan. 30 (HealthDay News) -- For patients with musculoskeletal problems, PhysioDirect, a service which invites patients to telephone a physical therapist for initial assessment and advice, followed by face-to-face physical therapy if necessary, is similarly effective to usual care, but is associated with slightly lower patient satisfaction, according to a study published online Jan. 29 in BMJ.

Chris Salisbury, M.D., M.B., Ch.B., of the University of Bristol in the United Kingdom, and colleagues conducted a pragmatic randomized controlled trial to assess equivalence in clinical effectiveness among patients with musculoskeletal problems randomized in a 2:1 ratio to PhysioDirect (1,506 patients) or usual care (743 patients); 85 percent of patients (1,283 and 629 patients, respectively) provided outcome data at six months.

The researchers found that, compared with usual-care patients, PhysioDirect patients had fewer face-to-face appointments, a shorter waiting time, and lower rates of nonattendance. The short-form 36 version 2 physical component score was similar between the groups after six months' follow-up. At the six-week follow-up, there was a trend toward slightly greater improvement in health outcome measures with PhysioDirect, but no difference was noted at six months. Compared with usual-care patients, PhysioDirect patients were no more satisfied with access to physical therapy and, at six months, they had slightly lower satisfaction overall.

"This study provides justification for PhysioDirect as a safe and effective way of reducing delays for advice about musculoskeletal problems for patients referred by general practitioners for [physical therapy]," the authors write. "But, in view of the slight reduction in patient satisfaction, our results do not provide a compelling argument in favor of PhysioDirect."

Full Text (http://www.bmj.com/content/346/bmj.f43 )