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肌骨系统疾病初级保健中物理治疗师第一接触治疗角色的有效性和可接受性的叙述性综合评价。

A narrative synthesis of the effectiveness and acceptability of musculoskeletal first contact physiotherapy practitioner roles in primary care.

机构信息

Midlands Partnership NHS Foundation Trust, Stafford, UK.

Dorset Healthcare University NHS Foundation Trust, Poole, UK.

出版信息

Musculoskeletal Care. 2024 Jun;22(2):e1875. doi: 10.1002/msc.1875.

Abstract

BACKGROUND

Musculoskeletal (MSK) First Contact Practitioners (FCP), diagnostic clinicians with expertise in the assessment and management of undifferentiated MSK conditions in primary care have been widely employed in the United Kingdom since 2020. The role aims to bring specialist clinical knowledge to patients at the first point of contact and reduce the burden on existing primary care services. Since the national adoption of the role, little has been published to support the effectiveness or acceptability of the role. This narrative synthesis review aims to highlight and summarise the current body of evidence.

METHODOLOGY

An adapted systematic review was carried out to inform thematic reporting and narrative synthesis, under the sub-themes of clinical outcomes, patient satisfaction, acceptability and cost analysis.

RESULTS

Eight publications were included in the review, reporting improvements in clinical outcomes in patients seen by MSK FCP, patient satisfaction and general acceptability of the role. However, all data were collected from observational studies and qualitative sources, some of which were found to be of low methodological quality.

CONCLUSION

Although the review identified consistent positivity relating to effectiveness, satisfaction and acceptability across the reviewed publications, conclusions are limited due to the relatively recent introduction of the FCP role leading to limited availability of relevant publications.

摘要

背景

自 2020 年以来,肌肉骨骼(MSK)初诊从业者(FCP)在英国得到了广泛应用。他们是在初级保健中具有评估和管理未分化 MSK 疾病专业知识的诊断临床医生,旨在将专科临床知识带给初诊患者,并减轻现有初级保健服务的负担。自该角色在全国范围内采用以来,很少有关于该角色的有效性或可接受性的研究发表。本叙述性综述旨在强调和总结当前的证据。

方法

采用改良的系统评价方法进行主题报告和叙述性综合分析,分为临床结局、患者满意度、可接受性和成本分析三个亚主题。

结果

综述共纳入 8 篇文献,报告了 MSK FCP 就诊患者的临床结局改善、患者满意度和对该角色的普遍可接受性。然而,所有数据均来自观察性研究和定性资料,其中一些研究的方法学质量较低。

结论

尽管综述中所有文献均一致表明该角色在有效性、满意度和可接受性方面具有积极作用,但由于 FCP 角色的引入相对较新,相关文献的可获得性有限,因此结论受到限制。

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