Chu Jackie, Withers Hannah G, Glinsky Joanne V, Liu Hueiming, Jennings Matthew D, Starkey Ian J, Palmer Blake, Parmeter Rachel, Cruwys Jackson J, Boulos Max, Jordan Ian, Duong Maggie, Duong Kitty, Wong David, Lambert Tara E, Lucas Barbara R, Taylor Deborah, Maher Christopher G, Sherrington Catherine, Zadro Joshua R, Harvey Lisa A
Kolling Institute, The University of Sydney Faculty of Medicine and Health, St Leonards, New South Wales, Australia.
Northern Sydney Local Health District, John Walsh Centre for Rehabilitation Research, St Leonards, New South Wales, Australia.
BMJ Open. 2025 Aug 28;15(8):e097770. doi: 10.1136/bmjopen-2024-097770.
The objectives of this process evaluation were to explain the results of the REFORM (REhabilitation FOR Musculoskeletal conditions) trial and identify potential facilitators and barriers to the future rollout of a remotely delivered physiotherapy model of care.
Outpatient physiotherapy units in five government-funded public hospitals in Sydney, Australia.
This process evaluation was run alongside the REFORM trial. The REFORM trial (n=210) set out to determine whether remotely delivered physiotherapy (with one initial face-to-face session with a physiotherapist) was as good or better than a course of face-to-face physiotherapy. The process evaluation was informed by The UK Medical Research Council Process Evaluation Guidance. It was also based on the Realist Evaluation and the dimensions of the Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) Framework. Qualitative and quantitative data were collected. The qualitative data included semistructured interviews. The quantitative data included audits of screening logs and participants' self-reported satisfaction with service delivery. A thematic analysis using both inductive and deductive approaches was used for qualitative analysis. Multiple data were used to triangulate the process evaluation findings.
Quantitative data were collected on 210 participants. Qualitative interviews were conducted with 20 participants, 15 physiotherapists and 5 stakeholders.
Some participants valued the convenience and accessibility of remotely delivered physiotherapy. It was also deemed to have the potential of improving the efficiency in the way physiotherapy is delivered. The findings from the RE-AIM framework were mixed. For example, the was limited, and the and were inconsistent across sites.
Remotely delivered physiotherapy has the potential to be rolled out across Australian clinical settings to participants similar to the REFORM trial. However, further research involving participants with different types and severity of musculoskeletal conditions is needed to improve the generalisability of our findings. Adoption might be improved with a hybrid model of care where physiotherapists' and patients' preferences are met.
ACTRN12619000065190.
本过程评估的目的是解释REFORM（肌肉骨骼疾病康复）试验的结果，并确定远程提供物理治疗护理模式未来推广的潜在促进因素和障碍。
澳大利亚悉尼五家政府资助的公立医院的门诊物理治疗科。
本过程评估与REFORM试验同步进行。REFORM试验（n = 210）旨在确定远程提供的物理治疗（与物理治疗师进行一次初始面对面会诊）是否与面对面物理治疗疗程一样好或更好。该过程评估参考了英国医学研究理事会过程评估指南。它还基于现实主义评估以及覆盖范围、有效性、采用、实施和维持（RE-AIM）框架的维度。收集了定性和定量数据。定性数据包括半结构化访谈。定量数据包括筛查日志审核和参与者对服务提供的自我报告满意度。定性分析采用归纳和演绎相结合的主题分析法。使用多种数据对过程评估结果进行三角验证。
收集了210名参与者的定量数据。对20名参与者、15名物理治疗师和5名利益相关者进行了定性访谈。
一些参与者重视远程提供物理治疗的便利性和可及性。它还被认为有可能提高物理治疗的提供效率。RE-AIM框架的结果喜忧参半。例如，覆盖范围有限，不同地点的采用率和实施情况不一致。
远程提供的物理治疗有可能在澳大利亚临床环境中推广到与REFORM试验类似的参与者。然而，需要对患有不同类型和严重程度肌肉骨骼疾病的参与者进行进一步研究，以提高我们研究结果的普遍性。采用物理治疗师和患者偏好均得到满足的混合护理模式可能会提高采用率。
ACTRN12619000065190。
