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FCPP 预约后的基层医疗复诊:一项全国性回顾性服务评估

Primary Care Reattendance Following an FCPP Appointment: A National Retrospective Service Evaluation.

作者信息

Bradford Ben, Collier Thomas Samuel, Freeman Michael, Goodwin Rob

机构信息

Pure Unity Health, Norwich, UK.

School of Medicine, University of Nottingham, Nottingham, UK.

出版信息

Musculoskeletal Care. 2025 Jun;23(2):e70143. doi: 10.1002/msc.70143.

DOI:10.1002/msc.70143
PMID:40515757
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12198934/
Abstract

BACKGROUND

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.

AIM

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.

DESIGN AND SETTING

National, retrospective service evaluation from 70 primary care networks (PCNs) across England.

METHOD

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.

RESULTS

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.

CONCLUSION

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.

摘要

背景

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。

目的

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。

设计与设置

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。

方法

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。

结果

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。

结论

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。

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本文引用的文献

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First contact physiotherapy: an evaluation of clinical effectiveness and costs.首诊物理治疗:临床疗效和成本评估。
Br J Gen Pract. 2024 Sep 26;74(747):e717-e726. doi: 10.3399/BJGP.2023.0560. Print 2024 Oct.
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Patient access to first contact practitioner physiotherapists in the UK: A national survey.英国患者获得首诊物理治疗师服务的情况:一项全国性调查。
Musculoskeletal Care. 2023 Dec;21(4):1554-1562. doi: 10.1002/msc.1834. Epub 2023 Oct 14.
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The experiences of physiotherapy independent prescribing in primary care: implications for practice.物理治疗独立处方在初级保健中的体验:对实践的启示。
Prim Health Care Res Dev. 2023 Apr 20;24:e28. doi: 10.1017/S1463423623000142.
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A multi-site prospective, observational study of physiotherapist independent prescribing activity across musculoskeletal clinics in the United Kingdom.一项在英国肌肉骨骼诊所进行的、针对物理治疗师独立处方活动的多地点前瞻性观察性研究。
Musculoskelet Sci Pract. 2022 Oct;61:102616. doi: 10.1016/j.msksp.2022.102616. Epub 2022 Jun 29.
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The prevalence of musculoskeletal presentations in general practice: an epidemiological study.骨骼肌系统疾病在全科医疗中的流行情况:一项流行病学研究。
Fam Pract. 2023 Feb 9;40(1):68-74. doi: 10.1093/fampra/cmac055.
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Barriers and facilitators to implementation of non-medical independent prescribing in primary care in the UK: a qualitative systematic review.英国初级保健中非医疗独立处方实施的障碍和促进因素:定性系统评价。
BMJ Open. 2022 Jun 8;12(6):e052227. doi: 10.1136/bmjopen-2021-052227.
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One in three GPs intends to quit within five years, survey finds.调查发现,三分之一的全科医生打算在五年内辞职。
BMJ. 2022 Apr 14;377:o983. doi: 10.1136/bmj.o983.
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Patient satisfaction with the first contact physiotherapy service: Results from the national evaluation survey.患者对首诊物理治疗服务的满意度:全国评估调查结果。
Musculoskeletal Care. 2022 Jun;20(2):363-370. doi: 10.1002/msc.1599. Epub 2021 Oct 28.
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Physiotherapy. 2021 Dec;113:199-208. doi: 10.1016/j.physio.2021.08.002. Epub 2021 Aug 6.
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Advanced practice physiotherapists are effective in the management of musculoskeletal disorders: a systematic review of systematic reviews.高级实践物理治疗师在管理肌肉骨骼疾病方面是有效的:系统评价的系统评价。
Physiotherapy. 2021 Dec;113:116-130. doi: 10.1016/j.physio.2021.08.005. Epub 2021 Aug 8.