A case study – PhysioDirect telephone assessment and advice services for patients with musculoskeletal problems, England

  • A pragmatic, individually randomized controlled trial comparing PhysioDirect and usual care was conducted in four typical community physiotherapy services in four different areas of England (Bristol, Somerset, Stoke-on-Trent, and Cheshire)
  • Participants: Adults (aged ≥18 years) referred by general practitioners or who referred themselves for physiotherapy for a musculoskeletal problem
  • Interventions compared:
    • usual care – patients with musculoskeletal problems being referred by general practitioners to a physiotherapist (patients join a waiting list for the next available face-to-face appointment, and could wait for several weeks)
    • PhysioDirect –patients invited to telephone a physiotherapist for initial assessment and advice; at the end of the call, most patients were sent written advice about self management and exercises and invited to telephone back after two to four weeks to discuss progress (face-to-face physiotherapy offered if necessary)
  • Outcome measures:
    • Numbers of appointments, waiting time for treatment, and non-attendance rates;
    • Physical health (SF-36v2 physical component score) at six months
    • Mental component score and scales from the SF-36v2, time lost from work, patient satisfaction and preference
    • Costs and Quality-adjusted life years (QALYs)

Fit for Work Global Alliance is led by The Work Foundation and supported by AbbVie.

Toolkit partners:

Toolkit sponsor:

Fit for Work Global Alliance is a multi-stakeholder initiative, driving policy and practice change across the work and health agendas in Europe and worldwide (over 35 countries). The vision is to raise awareness of the facts of MSKs and make the case for more investment in sustainable healthcare by promoting and supporting the implementation of early intervention practices. Fit for Work is led by The Work Foundation – Lancaster University, which is also providing the Secretariat. AbbVie is founding sponsor since 2008. All the research is produced independently by The Work Foundation, with full editorial control resting with the think-thank alone.

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