Time to analgesia for musculoskeletal presentations in Tasmanian emergency departments: a case-controlled comparative observational study investigating the impact of advanced practice physiotherapists.

Abstract

Objective To assess the timeliness of analgesia provided to patients presenting with musculoskeletal conditions, by advanced practice physiotherapists, medical officers and nurse practitioners in two Tasmanian emergency departments. Methods A retrospective case-controlled comparative observational study collected patient data over a 6 month period. Index cases were consecutive cases treated by an advanced practice physiotherapist, with a medical and nurse practitioner cohort case-matched based on clinical and demographic factors. Time to analgesia from initial triage and time to analgesia from patient allocation to health professional groups were analysed using Mann-Whitney U -test. Further assessment comparing between-group differences in access to analgesia within 30 and 60 min of emergency department triage was included. Results Two hundred and twenty-four patients who received analgesia while in the primary care of advanced practice physiotherapists were matched against 308 others. Median time to analgesia for the advanced practice physiotherapy group was 40.5 min compared with 59 min in the comparison group (P  = 0.001). Allocation to analgesia time for the advanced practice physiotherapy group was 27 min, compared with 30 min in the comparison group (P  = 0.465). Access to analgesia within 30 min of presentation to the emergency department is low (36.1% vs 30.8%, P  = 0.175). Conclusion For musculoskeletal presentations in two Tasmanian emergency departments, patients received more timely analgesia when in the care of an advanced practice physiotherapist compared with medical or nurse practitioner care. Further improvements in analgesia access are possible, with time from allocation to analgesia a potential target for intervention.