Fysioterapeuter i almen praksis - Et uforløst potentiale

Studenteropgave: Kandidatspeciale og HD afgangsprojekt

  • Jakob Leth Matthiesen
  • Gustav Færch Ussing
  • Simon Bay Nielsen
4. semester, Muskuloskeletal Fysioterapi (cand.san.), kandidat (Kandidatuddannelse)
Background: There is a growing demand for general practitioners (GP) in Denmark. One way
to accommodate the demand of GPs is to implement physiotherapists as a first point of contact
for patients with musculoskeletal (MSK) complaints. However, the quality of this model of care
has not yet been investigated in a Danish setting. The aim of this project is to evaluate the
quality of a first point of contact physiotherapists providing MSK care, as an alternative to GPs
in a Danish setting.
Method: A retrospective journal audit was conducted using medical records, and a separate
consecutive non-randomised study of patient satisfaction of patients visiting a Danish primary
healthcare centre in the period 01.11.2020 – 04.03.2021. Additionally, a systematic literature
search was carried out in March 2021 (PubMed, CINAHL and EMBASE) to identify relevant
outcomes the journal audit and patient satisfaction study was not able to. The overall outcomes
were: The ability to diagnose the problem, number of referrals, patient satisfaction, missed serious pathology/adverse events, work-related sick leave, function, pain, and health-related quality of life.
Results: Journal audits from 186 patients with MSK complaints were available for analysis. A
subgroup of 98 patients answered a patient satisfaction questionnaire. The results indicated an
acceptable diagnostic ability and an acceptable patient satisfaction. The number of referrals
were higher compared to the standard and therefore considered unacceptable. Six studies met
the eligibility criteria and indicated that there was no difference between physiotherapists and
GPs regarding missed serious pathology or adverse events. Patients accessed by a physiotherapist were overall less likely to report work-related sick leave compared to those accessed
by a GP. There were no differences in function, pain, or quality of life between patients consulted by a physiotherapist or a GP.
Conclusion: It appears that physiotherapists as a primary contact are able to manage patients
with MSK complaints in a Danish general practice. Due to varying methodological quality, the
results of the thesis report should be interpreted with caution.
Udgivelsesdato1 jun. 2021
Antal sider51
ID: 413426999