PDF(Pubmed)
Abstract：
UNASSIGNED: Worldwide many countries provide direct access in physiotherapy. The aim of this scoping review was to synthesize the available evidence on the quality of primary care musculoskeletal physiotherapy from different perspectives.
UNASSIGNED: Systematic searches were conducted in three databases up to September 2022. Studies were included when regarding assessment of at least one of the following perspectives: patient (quality of Life, patient satisfaction, pain, functioning, adverse events), provider (treatment compliance, responsibility, liability, status, prestige, job satisfaction), and society (number of referrals, amount of medical imaging, medication use, number of sessions needed for rehabilitation, and overall costs and cost-effectiveness). Selection and methodological quality assessment of systematic reviews were performed. Data extraction and analysis were performed separately for systematic reviews and individual primary studies.
UNASSIGNED: Five systematic reviews as well as 17 primary studies were included. From a patient perspective, no significant effect of direct access was found for pain and a tendency in favour of direct access was found for quality of life, functioning, and well-being. Concerning providers, higher treatment compliance was found in direct access to physiotherapy and decision-making was more accurate. From a societal perspective, significant differences in favour of direct access physiotherapy were found for waiting time, prescribed medication, and medical imaging. In addition, there was a tendency towards lower health care costs.
UNASSIGNED: Emerging evidence suggests that direct access physiotherapy could provide at least equal quality of care for patients and better opportunities for providers and the society on selected outcomes.
UNASSIGNED: Systematic searches were conducted in three databases up to September 2022. Studies were included when regarding assessment of at least one of the following perspectives: patient (quality of Life, patient satisfaction, pain, functioning, adverse events), provider (treatment compliance, responsibility, liability, status, prestige, job satisfaction), and society (number of referrals, amount of medical imaging, medication use, number of sessions needed for rehabilitation, and overall costs and cost-effectiveness). Selection and methodological quality assessment of systematic reviews were performed. Data extraction and analysis were performed separately for systematic reviews and individual primary studies.
UNASSIGNED: Five systematic reviews as well as 17 primary studies were included. From a patient perspective, no significant effect of direct access was found for pain and a tendency in favour of direct access was found for quality of life, functioning, and well-being. Concerning providers, higher treatment compliance was found in direct access to physiotherapy and decision-making was more accurate. From a societal perspective, significant differences in favour of direct access physiotherapy were found for waiting time, prescribed medication, and medical imaging. In addition, there was a tendency towards lower health care costs.
UNASSIGNED: Emerging evidence suggests that direct access physiotherapy could provide at least equal quality of care for patients and better opportunities for providers and the society on selected outcomes.
摘要：
■全球许多国家提供物理治疗的直接途径。这项范围审查的目的是从不同的角度综合有关初级保健肌肉骨骼理疗质量的可用证据。
■截至2022年9月，在三个数据库中进行了系统搜索。在评估以下至少一种观点时，纳入了研究：患者(生活质量，患者满意度,疼痛,功能,不良事件)，提供者(治疗依从性，责任,责任，status,声望,工作满意度)，和社会(推荐人数，医学成像的数量，药物使用,康复所需的课程数量，以及总成本和成本效益)。进行了系统评价的选择和方法学质量评估。对于系统评价和个别主要研究，分别进行数据提取和分析。
■纳入了5项系统综述和17项主要研究。从病人的角度来看，没有发现直接接触对疼痛的显著影响，并且发现了有利于直接接触的生活质量的趋势，功能,和幸福。关于提供者，在直接接受物理治疗时发现治疗依从性更高,决策更准确.从社会的角度来看,在等待时间上发现了支持直接进入物理治疗的显著差异，处方药,和医学成像。此外,有降低医疗保健成本的趋势。
■新的证据表明，直接获得物理治疗可以为患者提供至少同等质量的护理，并为提供者和社会提供更好的选择结果机会。
■截至2022年9月，在三个数据库中进行了系统搜索。在评估以下至少一种观点时，纳入了研究：患者(生活质量，患者满意度,疼痛,功能,不良事件)，提供者(治疗依从性，责任,责任，status,声望,工作满意度)，和社会(推荐人数，医学成像的数量，药物使用,康复所需的课程数量，以及总成本和成本效益)。进行了系统评价的选择和方法学质量评估。对于系统评价和个别主要研究，分别进行数据提取和分析。
■纳入了5项系统综述和17项主要研究。从病人的角度来看，没有发现直接接触对疼痛的显著影响，并且发现了有利于直接接触的生活质量的趋势，功能,和幸福。关于提供者，在直接接受物理治疗时发现治疗依从性更高,决策更准确.从社会的角度来看,在等待时间上发现了支持直接进入物理治疗的显著差异，处方药,和医学成像。此外,有降低医疗保健成本的趋势。
■新的证据表明，直接获得物理治疗可以为患者提供至少同等质量的护理，并为提供者和社会提供更好的选择结果机会。
