Bradford Ben, Collier Thomas Samuel, Freeman Michael, Goodwin Rob
Pure Unity Health, Norwich, UK.
School of Medicine, University of Nottingham, Nottingham, UK.
Musculoskeletal Care. 2025 Jun;23(2):e70143. doi: 10.1002/msc.70143.
Musculoskeletal (MSK) conditions equate to one third of a general practitioners (GP's) caseload. First contact practitioner physiotherapists (FCPPs) have been shown to be a clinically and cost-effective alternative to GPs for managing MSK conditions. However, their impact on primary care workload(s) requires further evaluation.
To determine the percentage of patients who, having seen an FCPP for a musculoskeletal disorder, then reattend with a GP, nurse practitioner (NP), or paramedic practitioner (PP) within 12 weeks, and the reasons for reattendance.
National, retrospective service evaluation from 70 primary care networks (PCNs) across England.
Data on the rate of and reasons for reattendance following an FCPP appointment were collected retrospectively between 01 January 2024 and 30 April 2024. Consent was obtained from each PCN/practice site. Extracted data consisted of patient demographics, and whether the patient reattended with a GP/NP/PP at three predetermined timepoints within 12 weeks. Reasons for reattendance at each time point were recorded against 8 predetermined criteria.
Two thousand one hundred forty out of 2725 patients (78.5%) did not reattend within 12 weeks of an FCPP appointment. Medication/analgesia prescribed was the most common reason for reattendance < 8 weeks and onward referral was the most common reason for reattendance between 8 and 12 weeks.
FCPPs do have a significant impact on reducing the burden of MSK conditions in primary care. Medication was the most common reason for reattendance, supporting the advanced practice component of the FCPP role.
肌肉骨骼疾病占全科医生工作量的三分之一。已有研究表明,首诊物理治疗师(FCPPs)在管理肌肉骨骼疾病方面是全科医生具有临床和成本效益的替代选择。然而,它们对初级保健工作量的影响需要进一步评估。
确定因肌肉骨骼疾病看过FCPP的患者在12周内再次就诊于全科医生、执业护士(NP)或护理人员(PP)的比例以及再次就诊的原因。
对英格兰70个初级保健网络(PCN)进行全国性回顾性服务评估。
回顾性收集2024年1月1日至2024年4月30日期间FCPP预约后再次就诊的比例和原因的数据。已获得每个PCN/医疗机构的同意。提取的数据包括患者人口统计学信息,以及患者是否在12周内的三个预定时间点再次就诊于全科医生/NP/PP。每次就诊的原因根据8个预定标准进行记录。
2725名患者中有2140名(78.5%)在FCPP预约后的12周内未再次就诊。复诊时间<8周时,复诊的最常见原因是开具药物/镇痛药,复诊时间在8至12周之间时,复诊的最常见原因是进一步转诊。
FCPPs确实对减轻初级保健中肌肉骨骼疾病的负担有显著影响。药物治疗是复诊的最常见原因,这支持了FCPP角色中的高级实践部分。