Qualitative Analysis of Physiotherapy Prescriptions From Primary Physicians for Patients With Back Musculoskeletal Disorders

NCT04177121 | Completed

• 1 other identifier: 2019 / 441 CERDB
• Study Type: observational
• Target: 60
• Locations: 1 country
• Sites: 1

Brief Summary

"Prescription in France is a major act of medical activity and must be in accordance with the scientific evidence. The use of physiotherapy by primary physicians is becoming more and more frequent and involves the performance of a prescription given to the patients so that they can access to their care. The optimization of the use of this treatment is based on the respect of several legal and regulatory provisions allowing physiotherapists (PT) to offer the most appropriate treatment to the patient. Although these professionals can carry out a physiotherapy diagnosis and the objectives of care, as well as the choice of the acts and the techniques which seem to them the most appropriate. The performance of their treatment remains conditioned by the indication to physiotherapy and the anatomical region formulated by the prescription of the primary physicians. Primary physicians don't have the right to include their diagnostic hypothesis on the physiotherapy prescription. Therefore, they could transmit to the PT a supplementary report including all useful information for the PT which could influence the progress of the treatment. It has been reported a frequent absence of diagnostic hypothesis formulated by the primary physicians to the PT to justify the indication to these treatment with the prescription. However, PT are led to formulate one or more diagnostic hypothesis following their clinical assessment. This can lead to questioning the interest of prescription for referring the patient from the primary physician to the PT. The qualitative study by Panchout et al shows that 97.8% of the french private physiotherapists included treat patients with musculoskeletal disorders and 95.5% received those with back disorders. Back musculoskeletal disorders are the most common conditions reported from french private PT. No French study has yet analyzed the quality of prescriptions formulated by primary physicians for private physiotherapists. Much foreign health systems have a different model of access to physiotherapy services compared to the French system, involving direct access physiotherapy for patients with musculoskeletal disorders. This care pathway gives patients the ability to refer themselves directly to a PT without having to see another health professional. Patients do not need a prescription in this model of access to physiotherapy care to use it. Thus, in order to optimize the relevance of the use of physiotherapy for patients with back musculoskeletal disorders, we propose a prospective and cross-sectional observational study of 60 physiotherapists. The first aim of this study is to assess the relevance of the physiotherapy indication from primary care physicians for patients with back musculoskeletal disorders and consulting physiotherapists.

Conditions

Back Musculoskeletal Disorders

Keywords

Musculoskeletal disorders; Physician; Physiotherapy; Referral

Outcome Measures

Primary Outcomes (3)

• ratio of physiotherapy prescription

  * Indication of physiotherapy (tltled present or absent), * Therapeutic goals (titled present or absent), * Number of sessions to be performed (titled present or absent and number), * Anatomic region(s) to be treated (titled present or absent and region defined), * Physiotherapy techniques to use (titled present or absent), * Contraindications to physiotherapy (titled present or absent),

  8 months

• ratio of associated medical report

  * Diagnostic hypothesis (present or absent), * Possible contraindications of certain physiotherapy techniques (present or absent).

  8 months

• ratio of conclusions of the physiotherapy diagnostic report

  * Indication to physiotherapy (yes/no), * Diagnostic hypothesis of physiotherapists (in accordance or not with that of the prescription), * Compliance with the prescription concerning the number and rhythm of the sessions to be performed, the anatomical region(s) to be treated and the physiotherapy techniques to be used (in accordance or not with that of the prescription)"

  8 months

Secondary Outcomes (1)

• Self-reported assessment for sociodemographic and clinical parameters from patients with back musculoskeletal disorders and physiotherapists included

  8 months

Interventions

qualitative analysis OTHER

Qualitative analysis of physiotherapy prescriptions

Eligibility Criteria

• Age: 18 Years - 99 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Probability Sample

Study Population

Patients with back musculoskeletal disorders

You may qualify if:

• Over the age of 18,
• Referred to a physiotherapist by a primary physician,
• Who have a prescription for physiotherapy,
• With back musculoskeletal disorders,
• Must be able to understand and speak French and legally consent to their participation in this study,
• Who did not oppose to participate in the study

You may not qualify if:

• Consulting the physiotherapist with a prescription for an indication other than a musculoskeletal condition of the spine
• Already taken in charge by a physiotherapist for another condition

Sponsors & Collaborators

• Assistance Publique - Hôpitaux de Paris: lead

Study Sites (1)

Robert Debre Hospital

Paris, 75019, France

Location

Related Publications (1)

• Demont A, Benaissa L, Recoque V, Desmeules F, Bourmaud A. Spinal pain patients seeking care in primary care and referred to physiotherapy: A cross-sectional study on patients characteristics, referral information and physiotherapy care offered by general practitioners and physiotherapists in France. PLoS One. 2022 Sep 6;17(9):e0274021. doi: 10.1371/journal.pone.0274021. eCollection 2022.

  PMID: 36067139 RESULT

MeSH Terms

Conditions

Musculoskeletal Diseases

Study Officials

• Aurélie BOURMAUD

  Assistance Publique - Hôpitaux de Paris

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: November 4, 2019
• First Posted: November 26, 2019
• Study Start: November 25, 2019
• Primary Completion: February 28, 2021
• Study Completion: March 16, 2021
• Last Updated: February 6, 2023

Record last verified: 2020-01

Locations

FR (1)