First Contact Physiotherapy: An evaluation of clinical effectiveness and costs.
Br J Gen Pract
; 2024 Mar 01.
Article
en En
| MEDLINE
| ID: mdl-38429110
ABSTRACT
BACKGROUND:
First Contact Physiotherapy Practitioners (FCPPs) are embedded within general practice, providing expert assessment, diagnosis and management plans for patients with musculoskeletal disorders (MSKDs), without the prior need for GP consultation.AIM:
To determine the clinical effectiveness and costs of FCPP-led compared to GP-led models of care. DESIGN ANDSETTING:
Multiple site case study design. UK GP practices.METHOD:
General Practice sites were recruited representing three models 1. GP-led care; 2. FCPPs who could not prescribe/inject (Standard (St)); 3. FCPPs who could prescribe/inject (Additional Qualifications (AQ)). Patient participants from each site completed clinical outcome data at baseline, 3 and 6 months. The primary outcome was the SF-36v.2 Physical Component Score (PCS). Healthcare usage was collected for 6 months.RESULTS:
N=426 adults were recruited from 46 practices across the UK. Non-inferiority analysis showed no significant difference in physical function (SF36-PCS) across all three arms at 6 months (p=0.999). At 3 months a significant difference in numbers improving was seen between arms 54.7% GP consultees; 72.4% FCPP-St, 66.4% FCPP-AQ; (p=0.037). No safety issues were identified. Following initial consultation, a greater proportion of patients received medication (including opioids) in the GP-led arm (44.7%) compared with FCPP-St (17.5%) and FCPP-AQ (22.8%); (p<0.001). NHS costs (initial consultation and over 6 months follow up) were significantly higher in the GP-led model (median £105.50) vs FCPP-St (£41) and FCPP-AQ (£44); (p<0.001).CONCLUSION:
FCPP led models provide safe, clinically effective and cost-beneficial management for patients with MSKDs in general practice and reduced opioid use in this cohort.
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Banco de datos:
MEDLINE
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En
Revista:
Br J Gen Pract
Año:
2024
Tipo del documento:
Article