Identifying goals, roles and tasks of extended scope physiotherapy in Dutch primary care- an exploratory, qualitative multi-step study.

Publisher: BioMed Central Country of Publication: England NLM ID: 101088677 Publication Model: Electronic Cited Medium: Internet ISSN: 1472-6963 (Electronic) Linking ISSN: 14726963 NLM ISO Abbreviation: BMC Health Serv Res Subsets: MEDLINE

Original Publication: London : BioMed Central, [2001-

Medicine* ; Physical Therapy Modalities* ; Professional Role*; Aged ; Child ; Cross-Sectional Studies ; Goals ; Humans ; Netherlands ; Primary Health Care ; Prospective Studies ; Qualitative Research ; Reproducibility of Results ; Retrospective Studies

Background: Rising healthcare costs, an increasing general practitioner shortage and an aging population have made healthcare organization transformation a priority. To meet these challenges, traditional roles of non-medical members have been reconsidered. Within the domain of physiotherapy, there has been significant interest in Extended Scope Physiotherapy (ESP). Although studies have focused on the perceptions of different stakeholders in relation to ESP, there is a large variety in the interpretation of ESP.
Aim: To identify a paradigm of ESP incorporating goals, roles and tasks, to provide a consistent approach for the implementation of ESP in primary care.
Methods: An exploratory, qualitative multi-step design was used containing a scoping review, focus groups and semi-structured interviews. The study population consisted of patients, physiotherapists, general practitioners and indirect stakeholders such as lecturers, health insurers and policymakers related to primary care physiotherapy. The main topics discussed in the focus groups and semi-structured interviews were the goals, skills and roles affiliated with ESP. The 'framework' method, developed by Ritchie & Spencer, was used as analytical approach to refine the framework.
Results: Two focus groups and twelve semi-structured interviews were conducted to explore stakeholder perspectives on ESP in Dutch primary care. A total of 11 physiotherapists, six general practitioners, five patients and four indirect stakeholders participated in the study. There was a lot of support for 'decreasing healthcare costs', 'tackling increased health demand' and 'improving healthcare effectiveness' as main goals of ESP. The most agreement was reached on 'triaging', 'referring to specialists' and 'ordering diagnostic imaging' as tasks fitting for ESP. Most stakeholders also supported 'working in a multidisciplinary team', 'working as a consultant' and 'an ESP role separated from a physiotherapist role' as roles of ESP.
Conclusions: Based on the scoping review, focus groups and interviews with direct and indirect stakeholders, it appears that there is sufficient support for ESP in the Netherlands. This study provides a clear presentation of how ESP can be conceptualized in primary care. A pilot focused on determining the feasibility of ESP in Dutch primary care will be the next step.

Erratum in: BMC Health Serv Res. 2021 Jan 29;21(1):102. (PMID: 33514349)

Emerg Med J. 2006 May;23(5):384-7. (PMID: 16627842)
Physiother Theory Pract. 2009 Nov;25(8):533-43. (PMID: 19925261)
BMC Nurs. 2017 Jan 18;16:6. (PMID: 28115913)
Physiother Can. 2011 Winter;63(1):94-103. (PMID: 22210986)
Physiother Can. 2008 Summer;60(3):224-38. (PMID: 20145755)
Musculoskeletal Care. 2003 Mar;1(1):65-70. (PMID: 20217665)
J Orthop Sports Phys Ther. 2011 Nov;41(11):829-37. (PMID: 22048788)
Physiother Can. 2011 Fall;63(4):434-42. (PMID: 22942521)
Healthc Q. 2008;11(2):62-6. (PMID: 18362522)
BMJ Open. 2015 Dec 09;5(12):e009740. (PMID: 26656024)
Implement Sci. 2010 Sep 20;5:69. (PMID: 20854677)
J Multidiscip Healthc. 2014 Jun 20;7:249-58. (PMID: 25018637)
Aust Health Rev. 2015 Jun;39(3):271-82. (PMID: 26629584)
Physiother Can. 2015 Spring;67(2):144-56. (PMID: 25931666)
BMC Musculoskelet Disord. 2012 Jun 21;13:107. (PMID: 22716771)
BMC Health Serv Res. 2009 Jun 02;9:88. (PMID: 19490639)
Healthc Q. 2007;10(2):88-91, 6. (PMID: 17491573)
J Health Serv Res Policy. 2011 Jan;16(1):51-8. (PMID: 21186320)
Public Health. 2015 Feb;129(2):110-6. (PMID: 25687709)
BMC Health Serv Res. 2015 Jul 01;15:252. (PMID: 26126998)
Clin Perform Qual Health Care. 1999 Jul-Sep;7(3):121-4. (PMID: 10848384)
Physiother Can. 2017;69(4):351-360. (PMID: 30369703)
J Bone Joint Surg Am. 2003 Sep;85(9):1710-5. (PMID: 12954829)
J Orthop Sports Phys Ther. 2009 Mar;39(3):221-9. (PMID: 19252261)
J Health Serv Res Policy. 2006 Oct;11(4):240-7. (PMID: 17018199)
Musculoskeletal Care. 2019 Jun;17(2):253-260. (PMID: 30993860)
BMC Musculoskelet Disord. 2016 Sep 21;17(1):400. (PMID: 27652824)

Keywords: Extended scope; Multi-step design; Physical therapy modalities; Primary health care

Date Created: 20210107 Date Completed: 20210427 Latest Revision: 20231110

20231110

PMC7788995

10.1186/s12913-020-05986-w

33407402