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Health effects of direct triaging to physiotherapists in primary care for patients with musculoskeletal disorders: a pragmatic randomized controlled trial

Abstract:
Background: Physiotherapists and general practitioners (GPs) both act as primary assessors for patients with musculoskeletal disorders in primary care. Previous studies have shown that initial triaging to physiotherapists at primary healthcare centres has advantages regarding efficiency in the work environment and utilization of healthcare. In this study, we aimed primarily to determine whether triaging to physiotherapists affects the progression of health aspects over time differently than traditional management with initial GP assessment. The secondary aim was to determine whether triaging to physiotherapists affects patients’ attitudes of responsibility for musculoskeletal disorders. Methods: This was a pragmatic trial where both recruitment and treatment strategies were determined by clinical, not study-related parameters, and was initiated at three primary care centres in Sweden. Working-age patients of both sexes seeking primary care for musculoskeletal disorders and nurse assessed as suitable for triaging to physiotherapists were randomized to initial consultations with either physiotherapists or GPs. They received self-assessment questionnaires before the initial consultation and were followed up at 2, 12, 26 and 52 weeks with the same questionnaires. Outcome measures were current and mean (3 months) pain intensities, functional disability, risk for developing chronic musculoskeletal pain, health-related quality of life and attitudes of responsibility for musculoskeletal conditions. Trends over time were analysed with a regression model for repeated measurements. Results: The physiotherapist-triaged group showed significant improvement for health-related quality of life at 26 weeks and showed consistent but nonsignificant tendencies to greater reductions of current pain, mean pain in the latest 3 months, functional disability and risk for developing chronic pain compared with traditional management. The triage model did not consistently affect patients’ attitudes of responsibility for musculoskeletal disorders. Conclusions: Triaging to physiotherapists for primary assessment in primary care leads to at least as positive health effects as primary assessment by GPs and can be recommended as an alternative management pathway for patients with musculoskeletal disorders. ClinicalTrials.gov identifier: NCT148611.
Author Listing: Lena Bornhöft;Maria Eh Larsson;Lena Nordeman;Robert Eggertsen;Jörgen Thorn
Volume: 11
Pages: None
DOI: 10.1177/1759720X19827504
Language: English
Journal: Therapeutic Advances in Musculoskeletal Disease

Therapeutic Advances in Musculoskeletal Disease

THER ADV MUSCULOSKEL

影响因子:4.1
是否综述期刊:否
是否OA:否
是否预警:不在预警名单内
发行时间:-
ISSN:1759-720X
发刊频率:-
收录数据库:SCIE/Scopus收录/DOAJ开放期刊
出版国家/地区:United States
出版社:SAGE Publications Inc.

期刊介绍

Therapeutic Advances in Musculoskeletal Disease delivers the highest quality peer-reviewed articles, reviews, and scholarly comment on pioneering efforts and innovative studies across all areas of musculoskeletal disease.

肌肉骨骼疾病的治疗进展提供了最高质量的同行评审文章,审查和学术评论的开拓性努力和创新的研究在肌肉骨骼疾病的所有领域。

年发文量 57
国人发稿量 8
国人发文占比 14.58%
自引率 2.4%
平均录取率 -
平均审稿周期 18 Weeks
版面费 -
偏重研究方向 Medicine-Rheumatology
期刊官网 https://uk.sagepub.com/en-gb/asi/journal/therapeutic-advances-musculoskeletal-disease
投稿链接 https://mc.manuscriptcentral.com/tamd

质量指标占比

研究类文章占比 OA被引用占比 撤稿占比 出版后修正文章占比
70.18% 92.38% - 0.00%

相关指数

影响因子
影响因子
年发文量
自引率
Cite Score

预警情况

时间 预警情况
2025年03月发布的2025版 不在预警名单中
2024年02月发布的2024版 不在预警名单中
2023年01月发布的2023版 不在预警名单中
2021年12月发布的2021版 不在预警名单中
2020年12月发布的2020版 不在预警名单中

JCR分区 WOS分区等级:Q1区

版本 按学科 分区
WOS期刊SCI分区
(2021-2022年最新版)
RHEUMATOLOGY Q2

中科院分区

版本 大类学科 小类学科 Top期刊 综述期刊
医学
3区
RHEUMATOLOGY
风湿病学
3区
2021年12月
基础版
医学
2区
RHEUMATOLOGY
风湿病学
2区
2021年12月
升级版
医学
3区
RHEUMATOLOGY
风湿病学
4区
2020年12月
旧的升级版
医学
3区
RHEUMATOLOGY
风湿病学
3区
2022年12月
最新升级版
医学
2区
RHEUMATOLOGY
风湿病学
3区