Barriers, facilitators and referral patterns of general practitioners, physiotherapists, and people with osteoarthritis to exercise

IF 3.1 3区医学 Q1 REHABILITATION

Physiotherapy Pub Date : 2024-07-24 DOI:10.1016/j.physio.2024.101416

Avantika Bhardwaj , Peter Hayes , Jacqui Browne , Stacey Grealis , Darragh Maguire , John O’Hora , Ian Dowling , Norelee Kennedy , Clodagh M. Toomey

{"title":"Barriers, facilitators and referral patterns of general practitioners, physiotherapists, and people with osteoarthritis to exercise","authors":"Avantika Bhardwaj , Peter Hayes , Jacqui Browne , Stacey Grealis , Darragh Maguire , John O’Hora , Ian Dowling , Norelee Kennedy , Clodagh M. Toomey","doi":"10.1016/j.physio.2024.101416","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Barriers and facilitators of general practitioners (GPs), physiotherapists (PTs), and people with hip and knee osteoarthritis (PwOA) may influence uptake of and referral to guideline-based exercise treatments for OA.</div></div><div><h3>Objective</h3><div>To identify barriers and facilitators of GPs, PTs and PwOA to uptake of and referral to exercise treatments for OA.</div></div><div><h3>Methods</h3><div>An online survey was circulated to GPs, PTs, and PwOA in Ireland from March to September 2021. Data were collected on demographics, barriers and facilitators, and referral patterns to exercise treatments for OA. Frequency distributions were used to illustrate demographics, barriers and facilitators, and referral patterns to exercise treatments for OA.</div></div><div><h3>Results</h3><div>388 stakeholders responded (GPs = 148; PTs = 154; PwOA = 86). Barriers and facilitators were related to (1) stakeholder (e.g., patient tiredness and fatigue), (2) healthcare setting (e.g., appropriate referrals from GP or other sources), and (3) treatment (e.g., low-cost community-based exercise programmes) factors. While 91% of GPs would refer PwOA to physiotherapy if no barriers existed, only 60% would in their current practice. Only 33% of PwOA reported receiving a GP referral to physiotherapy.</div></div><div><h3>Conclusion</h3><div>Stakeholder, healthcare setting and treatment barriers and facilitators of GPs, PTs, and PwOA influence uptake of and referral to exercise treatments for OA. Future strategies Future strategies addressing these factors may improve implementation of guideline-based management for OA.</div></div><div><h3>Contribution of the Paper</h3><div><ul><li><span>•</span><span><div>Despite an established evidence-based consensus, uptake of and referral to exercise as a first-line treatment for OA is suboptimal, partly influenced by the barriers and facilitators of stakeholders (e.g., GPs, PTs, and PwOA).</div></span></li><li><span>•</span><span><div>Barriers and facilitators that influence uptake of and referral to exercise treatments for OA are related to stakeholder, healthcare setting, and treatment factors.</div></span></li><li><span>•</span><span><div>Majority of PwOA are not receiving GP referrals to physiotherapy, and a mismatch between GPs intentions to and actual referrals to physiotherapy exists, primarily due to long waitlists to access services.</div></span></li><li><span>•</span><span><div>These findings may be adapted to inform strategies for the successful implementation of exercise treatments that are effective in encouraging guideline-based management of OA.</div></span></li></ul></div></div>","PeriodicalId":54608,"journal":{"name":"Physiotherapy","volume":"125 ","pages":"Article 101416"},"PeriodicalIF":3.1000,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Physiotherapy","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0031940624004255","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"REHABILITATION","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Barriers and facilitators of general practitioners (GPs), physiotherapists (PTs), and people with hip and knee osteoarthritis (PwOA) may influence uptake of and referral to guideline-based exercise treatments for OA.

Objective

To identify barriers and facilitators of GPs, PTs and PwOA to uptake of and referral to exercise treatments for OA.

Methods

An online survey was circulated to GPs, PTs, and PwOA in Ireland from March to September 2021. Data were collected on demographics, barriers and facilitators, and referral patterns to exercise treatments for OA. Frequency distributions were used to illustrate demographics, barriers and facilitators, and referral patterns to exercise treatments for OA.

Results

388 stakeholders responded (GPs = 148; PTs = 154; PwOA = 86). Barriers and facilitators were related to (1) stakeholder (e.g., patient tiredness and fatigue), (2) healthcare setting (e.g., appropriate referrals from GP or other sources), and (3) treatment (e.g., low-cost community-based exercise programmes) factors. While 91% of GPs would refer PwOA to physiotherapy if no barriers existed, only 60% would in their current practice. Only 33% of PwOA reported receiving a GP referral to physiotherapy.

Conclusion

Stakeholder, healthcare setting and treatment barriers and facilitators of GPs, PTs, and PwOA influence uptake of and referral to exercise treatments for OA. Future strategies Future strategies addressing these factors may improve implementation of guideline-based management for OA.

Contribution of the Paper

•
Despite an established evidence-based consensus, uptake of and referral to exercise as a first-line treatment for OA is suboptimal, partly influenced by the barriers and facilitators of stakeholders (e.g., GPs, PTs, and PwOA).
•
Barriers and facilitators that influence uptake of and referral to exercise treatments for OA are related to stakeholder, healthcare setting, and treatment factors.
•
Majority of PwOA are not receiving GP referrals to physiotherapy, and a mismatch between GPs intentions to and actual referrals to physiotherapy exists, primarily due to long waitlists to access services.
•
These findings may be adapted to inform strategies for the successful implementation of exercise treatments that are effective in encouraging guideline-based management of OA.

查看原文本刊更多论文

全科医生、物理治疗师和骨关节炎患者进行锻炼的障碍、促进因素和转诊模式

背景全科医生（GP）、物理治疗师（PT）以及髋关节和膝关节骨关节炎患者（PwOA）的障碍和促进因素可能会影响对基于指南的 OA 运动疗法的接受和转诊。调查收集了有关OA运动疗法的人口统计学、障碍和促进因素以及转诊模式的数据。结果388名利益相关者做出了回应（全科医生=148人；公共卫生医生=154人；残疾人=86人）。障碍和促进因素与（1）利益相关者（如患者的疲惫和疲劳）、（2）医疗环境（如全科医生或其他来源的适当转诊）和（3）治疗（如低成本的社区运动项目）因素有关。如果不存在任何障碍，91% 的全科医生会将老年残疾人转介到物理治疗机构，但在他们目前的工作中，只有 60% 的全科医生会这样做。结论全科医生、物理治疗师和 OA 患者的利益相关者、医疗环境和治疗障碍及促进因素会影响 OA 运动疗法的接受和转诊。本文贡献--尽管已有循证共识，但作为OA一线治疗方法的运动疗法的接受率和转诊率并不理想，部分原因是受到利益相关者（如全科医生、康复师和残疾人）的障碍和促进因素的影响、影响OA运动疗法的接受和转诊的障碍和促进因素与利益相关者、医疗环境和治疗因素有关。大多数PwOA没有接受全科医生转诊到物理治疗，全科医生转诊到物理治疗的意向和实际转诊之间存在不匹配，这主要是由于获得服务的等待时间过长。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Physiotherapy 医学-康复医学

CiteScore

6.40

自引率

3.00%

发文量

377

审稿时长

82 days

期刊介绍： Physiotherapy aims to publish original research and facilitate continuing professional development for physiotherapists and other health professions worldwide. Dedicated to the advancement of physiotherapy through publication of research and scholarly work concerned with, but not limited to, its scientific basis and clinical application, education of practitioners, management of services and policy. We are pleased to receive articles reporting original scientific research, systematic reviews or meta-analyses, theoretical or debate articles, brief reports and technical reports. All papers should demonstrate methodological rigour.