First contact physiotherapy: An evaluation of clinical effectiveness and costs.

Journal article

Walsh, Nicola, Halls, Serena, Thomas, Rachel, Berry, Alice, Liddiard, Cathy, Cupples, Margaret Elizabeth, Gage, Heather, Jackson, Dan, Cramp, Fiona, Stott, Hannah, Kersten, Paula, Jagosh, Justin, Foster, Dave and Williams, Peter 2024. First contact physiotherapy: An evaluation of clinical effectiveness and costs. The British Journal of General Practice : The Journal of the Royal College of General Practitioners. (2023), p. 05560. https://doi.org/10.3399/BJGP.2023.0560
AuthorsWalsh, Nicola, Halls, Serena, Thomas, Rachel, Berry, Alice, Liddiard, Cathy, Cupples, Margaret Elizabeth, Gage, Heather, Jackson, Dan, Cramp, Fiona, Stott, Hannah, Kersten, Paula, Jagosh, Justin, Foster, Dave and Williams, Peter
AbstractFirst 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. To determine the clinical effectiveness and costs of FCPP-led compared to GP-led models of care. Multiple site case study design. UK GP practices. 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. 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). 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. [Abstract copyright: Copyright © 2024, The Authors.]
KeywordsMuskuloskeletal; Costs; Physiotherapy
Year2024
JournalThe British Journal of General Practice : The Journal of the Royal College of General Practitioners
Journal citation(2023), p. 05560
PublisherRoyal College of General Practitioners
ISSN1478-5242
Digital Object Identifier (DOI)https://doi.org/10.3399/BJGP.2023.0560
https://doi.org/BJGP.2023.0560
Official URLhttps://bjgp.org/content/early/2024/02/05/BJGP.2023.0560.long
Publication dates
Online01 Mar 2024
Publication process dates
Accepted22 Jan 2024
Deposited26 Sep 2024
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Open
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