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REVIEW PAPER
New models of care integrating more autonomous roles for physiotherapists: a narrative review
1
Université Paris Cité, Inserm, ECEVE, Paris, France
2
Physiotherapy School, University of Orléans, Orléans, France
3
Physiotherapy School, Grenoble Alpes University, Grenoble, France
4
INSERM, Institut Pierre Louis d’Épidémiologie et de Santé Publique, PEPITES team, Sorbonne University, Paris, France
5
School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia
6
School of Rehabilitation, Faculty of Medicine, University of Montreal, Montreal, Canada
7
Maisonneuve-Rosemont Hospital Research Centre, University of Montreal Affiliated Research Centre, Montreal, Canada
Submission date: 2020-07-25
Acceptance date: 2020-11-05
Publication date: 2022-09-26
Physiother Quart. 2022;30(3):91-98
KEYWORDS
TOPICS
ABSTRACT
With the increased prevalence of non-communicable diseases and chronic disorders, including musculoskeletal disorders, access to care is limited in many health care systems and new multidisciplinary collaborative models of care have now been implemented in several countries in an effort to improve access to care. The paper aimed to describe the characteristics and present relevant evidence supporting different models of care that integrate physiotherapists as primary or secondary care practitioners for the management of patients with non-communicable diseases or chronic disorders. On the basis of a literature review up to August 2020 in 4 major bibliographical databases, we searched for studies of any design, including systematic reviews with or without meta-analysis and position statements, that were related to direct access physiotherapy and advanced practice physiotherapy models of care. The impact of direct access physiotherapy and advanced practice physiotherapy models of care is presented in terms of clinical outcomes, patient satisfaction, health care resource use and costs. These models appear to provide equal or better outcomes in terms of access to care, quality of care, and patients’ satisfaction. The strength of the evidence is variable, and outcomes vary depending on clinical settings, roles of physiotherapists, and characteristics of patients. This review highlights that these enhanced roles for physiotherapists, such as diagnosing, ordering diagnostic tests, or referring patients to physicians, in both primary and secondary care settings, are beneficial and may help optimize patients’ journey by providing earlier access to effective and efficient services compared with physician-led usual care models.
REFERENCES (99)
1.
Bennett JE, Stevens GA, Mathers CD, Bonita R, Rehm J, Kruk ME, et al. NCD Countdown 2030: worldwide trends in non-communicable disease mortality and progress towards Sustainable Development Goal target 3.4. Lancet. 2018;392(10152):1072–1088; doi: 10.1016/S0140-6736(18)31992-5.
2.
GBD 2015 Risk Factors Collaborators. Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016;388(10053):1659–1724; doi: 10.1016/S0140-6736(16)31679-8.
3.
Briggs AM, Woolf AD, Dreinhöfer K, Homb N, Hoy DG, Kopansky-Giles D, et al. Reducing the global burden of musculoskeletal conditions. Bull World Health Organ. 2018;96(5):366–368; doi: 10.2471/BLT.17.204891.
4.
World Health Organization. Global action plan for the prevention and control of noncommunicable diseases 2013–2020. Geneva: WHO; 2013. Available from: https://apps.who.int/iris/rest....
5.
European Commission. A new drive for primary care in Europe: rethinking the assessment tools and methodologies. Report of the expert group on health systems performance assessment. Luxembourg: Publications Office of the European Union; 2018. Available from: https://op.europa.eu/en/public....
6.
World Confederation for Physical Therapy. Autonomy: policy statement. 2019. Available from: https://www.wcpt.org/policy/ps....
7.
World Confederation for Physical Therapy. Education: policy statement. 2019. Available from: https://www.wcpt.org/policy/ps....
8.
Lin I, Wiles L, Waller R, Goucke R, Nagree Y, Gibberd M, et al. What does best practice care for musculoskeletal pain look like? Eleven consistent recommendations from high-quality clinical practice guidelines: systematic review. Br J Sports Med. 2020;54(2):79–86; doi: 10.1136/bjsports-2018-099878.
9.
Liu X, Hanney WJ, Masaracchio M, Kolber MJ, Zhao M, Spaulding AC, et al. Immediate physical therapy initiation in patients with acute low back pain is associated with a reduction in downstream health care utilization and costs. Phys Ther. 2018;98(5):336–347; doi: 10.1093/ptj/pzy023.
10.
Veerbeek JM, van Wegen E, van Peppen R, van der Wees PJ, Hendriks E, Rietberg M, et al. What is the evidence for physical therapy poststroke? A systematic review and meta-analysis. PLoS One. 2014;9(2):e87987; doi: 10.1371/journal.pone.0087987.
11.
Burridge J, Alt Murphy M, Buurke J, Feys P, Keller T, Klamroth-Marganska V, et al. A systematic review of international clinical guidelines for rehabilitation of people with neurological conditions: what recommendations are made for upper limb assessment? Front Neurol. 2019;10:567; doi: 10.3389/fneur.2019.00567.
12.
JCS Joint Working Group. Guidelines for rehabilitation in patients with cardiovascular disease (JCS 2012). Circ J. 2014;78(8):2022–2093; doi: 10.1253/circj.cj-66-0094.
13.
Bury TJ, Stokes EK. A global view of direct access and patient self-referral to physical therapy: implications for the profession. Phys Ther. 2013;93(4):449–459; doi: 10.2522/ptj.20120060.
14.
World Confederation for Physical Therapy. Survey reveals global state of the physical therapy profession. 2019. Available from: https://www.wcpt.org/news/surv....
15.
World Confederation for Physical Therapy. Advanced physical therapy practice: policy statement. 2019. Available from: https://www.wcpt.org/policy/ps....
16.
World Confederation for Physical Therapy. Direct access and patient/client self-referral to physical therapy: policy statement. 2019. Available from: https://www.wcpt.org/policy/ps....
17.
Galley P. “Ethical principles and patient referral”. Aust J Physiother. 1975;21(3):97–100; doi: 10.1016/S0004-9514(14)61213-7.
18.
Galley P. Patient referral and the physiotherapist. Aust J Physiother. 1976;22(3):117–120; doi: 10.1016/S0004-9514(14)61008-4.
19.
Galley P. Physiotherapists as first-contact practitioners – new challenges and responsibilities in Australia. Physiotherapy. 1977;63(8):246–248.
20.
Kruger J. Patient referral and the physiotherapist: three decades later. J Physiother. 2010;56(4):217–218; doi: 10.1016/s1836-9553(10)70001-1.
21.
Greenham H, Moran P. Pathways to managing female urinary incontinence. Womens Health Med. 2005;2(6):10–14; doi: 10.1383/wohm.2005.2.6.10.
22.
Donato EB, DuVall RE, Godges JJ, Zimmerman GJ, Greathouse DG. Practice analysis: defining the clinical practice of primary contact physical therapy. J Orthop Sports Phys Ther. 2004;34(6):284–304; doi: 10.2519/jospt.2004.34.6.284.
23.
Demont A, Bourmaud A, Kechichian A, Desmeules F. The impact of direct access physiotherapy compared to primary care physician led usual care for patients with musculoskeletal disorders: a systematic review of the literature. Disabil Rehabil. 2021;43(12):1637–1648; doi: 10.1080/09638288.2019.1674388.
24.
Babatunde OO, Bishop A, Cottrell E, Jordan JL, Corp N, Humphries K, et al. A systematic review and evidence synthesis of non-medical triage, self-referral and direct access services for patients with musculoskeletal pain. PLoS One. 2020;15(7):e0235364; doi: 10.1371/journal.pone.0235364.
25.
Goodwin RW, Hendrick PA. Physiotherapy as a first point of contact in general practice: a solution to a growing problem? Prim Health Care Res Dev. 2016;17(5):489–502; doi: 10.1017/S1463423616000189.
26.
Holdsworth LK, Webster VS. Direct access to physiotherapy in primary care: now? – and into the future? Physiotherapy. 2004;90(2):64–72; doi: 10.1016/j.physio.2004.01.005.
27.
Ludvigsson ML, Enthoven P. Evaluation of physiotherapists as primary assessors of patients with musculoskeletal disorders seeking primary health care. Physiotherapy. 2012;98(2):131–137; doi: 10.1016/j.physio.2011.04.354.
28.
Brooks G, Dripchak S, Vanbeveren P, Allaben S. Is a prescriptive or an open referral related to physical therapy outcomes in patients with lumbar spine-related problems? J Orthop Sports Phys Ther. 2008;38(3):109–115; doi: 10.2519/jospt.2008.2591.
29.
Bornhöft L, Larsson ME, Nordeman L, Eggertsen R, Thorn J. Health effects of direct triaging to physiotherapists in primary care for patients with musculoskeletal disorders: a pragmatic randomized controlled trial. Ther Adv Musculoskelet Dis. 2019;11:1759720X19827504; doi: 10.1177/1759720X19827504.
30.
Bishop A, Ogollah RO, Jowett S, Kigozi J, Tooth S, Protheroe J, et al. STEMS pilot trial: a pilot cluster randomised controlled trial to investigate the addition of patient direct access to physiotherapy to usual GP-led primary care for adults with musculoskeletal pain. BMJ Open. 2017;7(3):e012987; doi: 10.1136/bmjopen-2016-012987.
31.
Holdsworth LK, Webster VS, McFadyen AK, The Scottish Physiotherapy Self Referral Study Group. Are patients who refer themselves to physiotherapy different from those referred by GPs? Results of a national trial. Physiotherapy. 2006;92(1):26–33; doi: 10.1016/j.physio.2005.11.002.
32.
Mallett R, Bakker E, Burton M. Is physiotherapy self-referral with telephone triage viable, cost-effective and beneficial to musculoskeletal outpatients in a primary care setting? Musculoskeletal Care. 2014;12(4):251–260; doi: 10.1002/msc.1075.
33.
Overman SS, Larson JW, Dickstein DA, Rockey PH. Physical therapy care for low back pain. Monitored program of first-contact nonphysician care. Phys Ther. 1988;68(2):199–207; doi: 10.1093/ptj/68.2.199.
34.
Moore JH, McMillian DJ, Rosenthal MD, Weishaar MD. Risk determination for patients with direct access to physical therapy in military health care facilities. J Orthop Sports Phys Ther. 2005;35(10):674–678; doi: 10.2519/jospt.2005.35.10.674.
35.
Mintken PE, Pascoe SC, Barsch AK, Cleland JA. Direct access to physical therapy services is safe in a university student health center setting. J Allied Health. 2015;44(3):164–168.
36.
Ojha HA, Fritz JM, Malitsky AL, Wu J, Weiner MG, Brandi JA, et al. Comparison of physical therapy and physician pathways for employees with recent onset musculoskeletal pain: a randomized controlled trial. PM R. 2020;12(11):1071–1080; doi: 10.1002/pmrj.12382.
37.
Bishop A, Chen Y, Protheroe J, Ogollah RO, Bailey J, Lewis M, et al. Providing patients with direct access to musculoskeletal physiotherapy: the impact on general practice musculoskeletal workload and resource use. The STEMS-2 study. Physiotherapy. 2021;111:48–56; doi: 10.1016/j.physio.2020.04.006.
38.
Webster VS, Holdsworth LK, McFadyen AK, Little H, The Scottish Physiotherapy Self Referral Study Group. Self-referral, access and physiotherapy: patients’ knowledge and attitudes – results of a national trial. Physiotherapy. 2008;94(2):141–149; doi: 10.1016/j.physio.2007.11.003.
39.
Holdsworth LK, Webster VS, McFadyen AK. What are the costs to NHS Scotland of self-referral to physiotherapy? Results of a national trial. Physiotherapy. 2007;93(1):3–11; doi: 10.1016/j.physio.2006.05.005.
40.
Garrity BM, McDonough CM, Ameli O, Rothendler JA, Carey KM, Cabral HJ, et al. Unrestricted direct access to physical therapist services is associated with lower health care utilization and costs in patients with new-onset low back pain. Phys Ther. 2020;100(1):107–115; doi: 10.1093/ptj/pzz152.
41.
Pendergast J, Kliethermes SA, Freburger JK, Duffy PA. A comparison of health care use for physician-referred and self-referred episodes of outpatient physical therapy. Health Serv Res. 2012;47(2):633–654; doi: 10.1111/j.1475-6773.2011.01324.x.
42.
Bornhöft L, Thorn J, Svensson M, Nordeman L, Eggertsen R, Larsson MEH. More cost-effective management of patients with musculoskeletal disorders in primary care after direct triaging to physiotherapists for initial assessment compared to initial general practitioner assessment. BMC Musculoskelet Disord. 2019;20(1):186; doi: 10.1186/s12891-019-2553-9.
43.
Johnson MP, Abrams SL. Historical perspectives of autonomy within the medical profession: considerations for 21st century physical therapy practice. J Orthop Sports Phys Ther. 2005;35(10):628–636; doi: 10.2519/jospt.2005.35.10.628.
44.
Martinello N, Bhandari A, Santos J, Dinh T. The role of physiotherapy in Canada: contributing to a stronger health care system. Ottawa: The Conference Board of Canada; 2017. Available from: https://physiotherapy.ca/sites....
45.
Canadian Physiotherapy Association. Integrating physiotherapy into the primary health care model in New Brunswick. Available from: https://www.gnb.ca/0053/phc/pd....
46.
Basson A, Stewart A. Physiotherapy management of low back pain – a review of surveys. S Afr J Physiother. 2011;67(1):17–20; doi: 10.4102/sajp.v67i1.246.
47.
Derghazarian T, Simmonds MJ. Management of low back pain by physical therapists in Quebec: how are we doing? Physiother Can. 2011;63(4):464–473; doi: 10.3138/ptc.2010-04P.
48.
Gracey JH, McDonough SM, Baxter GD. Physiotherapy management of low back pain: a survey of current practice in Northern Ireland. Spine. 2002;27(4):406–411; doi: 10.1097/00007632-200202150-00017.
49.
Swinkels ICS, van den Ende CHM, van den Bosch W, Dekker J, Wimmers RH. Physiotherapy management of low back pain: does practice match the Dutch guidelines? Aust J Physiother. 2005;51(1):35–41; doi: 10.1016/s0004-9514(05)70051-9.
50.
Australian Physiotherapy Council. Guidelines for accreditation of entry-level physiotherapy practitioner programs of study. Australian Physiotherapy Council; 2017. Available from: https://documents.pub/document....
51.
Council of Canadian Physiotherapy University Programs. Entry-to-practice physiotherapy curriculum: content guidelines for Canadian university programs. 2009.
52.
Fennelly O, Desmeules F, O’Sullivan C, Heneghan NR, Cunningham C. Advanced musculoskeletal physiotherapy practice: informing education curricula. Musculoskelet Sci Pract. 2020;48:102174; doi: 10.1016/j.msksp.2020.102174.
53.
Moffatt F, Goodwin R, Hendrick P. Physiotherapy-as-first-point-of-contact-service for patients with musculoskeletal complaints: understanding the challenges of implementation. Prim Health Care Res Dev. 2018;19(2):121–130; doi: 10.1017/S1463423617000615.
54.
Anaf S. Physiotherapy’s role in emergency department settings: a qualitative investigation of emergency stakeholders’ perceptions. University of South Australia; 2008. Available from: https://researchonline.jcu.edu....
55.
Desmeules F, Roy J-S, MacDermid JC, Champagne F, Hinse O, Woodhouse LJ. Advanced practice physiotherapy in patients with musculoskeletal disorders: a systematic review. BMC Musculoskelet Disord. 2012;13(1):107; doi: 10.1186/1471-2474-13-107.
56.
Chartered Society of Physiotherapy. Advanced practice in physiotherapy. Understanding the contribution of advanced practice in physiotherapy to transforming lives, maximising independence and empowering populations. London: Chartered Society of Physiotherapy. Available from: https://www.appn.org.uk/cms/wp....
57.
Australian Physiotherapy Association. Position statement. Scope of practice. Available from: https://australian.physio/site....
58.
Morris J, Grimmer K, Gilmore L, Perera C, Waddington G, Kyle G, et al. Principles to guide sustainable implementation of extended-scope-of-practice physiotherapy workforce redesign initiatives in Australia: stakeholder perspectives, barriers, supports, and incentives. J Multidiscip Healthc. 2014;7:249–258; doi: 10.2147/JMDH.S59473.
59.
Physiotherapy Board of New Zealand. Physiotherapy ‘extended scope’ in New Zealand. An update to the profession following the Board’s survey in 2014. Available from: https://www.physioboard.org.nz....
60.
Chartered Society of Physiotherapy. Advanced practice physiotherapists in GP practices: a ‘how-to’ guide for implementation. Edinburgh: Chartered Society of Physiotherapy. Available from: https://www.csp.org.uk/system/....
61.
Halls S, Thomas R, Stott H, Cupples ME, Kersten P, Cramp F, et al. Provision of first contact physiotherapy in primary care across the UK: a survey of the service. Physiotherapy. 2020;108:2–9; doi: 10.1016/j.physio.2020.04.005.
62.
Noblet T, Marriott J, Hensman-Crook A, O’Shea S, Friel S, Rushton A. Independent prescribing by advanced physiotherapists for patients with low back pain in primary care: a feasibility trial with an embedded qualitative component. PLoS One. 2020;15(3):e0229792; doi: 10.1371/journal.pone.0229792.
63.
Monteith W, Turner H, McRitchie C, Downie F. Extended scope practitioner (physiotherapist) as first point of contact for musculoskeletal conditions in primary care. Physiotherapy. 2019;105(Suppl. 1):e95; doi: 10.1016/j.physio.2018.11.069.
64.
Downie F, McRitchie C, Monteith W, Turner H. Physiotherapist as an alternative to a GP for musculoskeletal conditions: a 2-year service evaluation of UK primary care data. Br J Gen Pract. 2019;69(682):e314–e320; doi: 10.3399/bjgp19X702245.
65.
Desmeules F, Toliopoulos P, Roy J-S, Woodhouse LJ, Lacelle M, Leroux M, et al. Validation of an advanced practice physiotherapy model of care in an orthopaedic outpatient clinic. BMC Musculoskelet Disord. 2013;14:162; doi: 10.1186/1471-2474-14-162.
66.
Razmjou H, Robarts S, Kennedy D, McKnight C, MacLeod AM, Holtby R. Evaluation of an advanced-practice physical therapist in a specialty shoulder clinic: diagnostic agreement and effect on wait times. Physiother Can. 2013;65(1):46–55; doi: 10.3138/ptc.2011-56.
67.
MacKay C, Davis AM, Mahomed N, Badley EM. Expanding roles in orthopaedic care: a comparison of physiotherapist and orthopaedic surgeon recommendations for triage. J Eval Clin Pract. 2009;15(1):178–183; doi: 10.1111/j.1365-2753.2008.00979.x.
68.
Kempson SM. Physiotherapy in an accident and emergency department. Accid Emerg Nurs. 1996;4(4):198–202; doi: 10.1016/s0965-2302(96)90081-8.
69.
Morris CD, Hawes SJ. The value of accident and emergency based physiotherapy services. J Accid Emerg Med. 1996;13(2):111–113; doi: 10.1136/emj.13.2.111.
70.
Council of Australian Governments. The National Health Reform Agreement – National Partnership Agreement on Improving Public Hospital Services. Available from: https://federalfinancialrelati....
71.
Thompson C, Williams K, Morris D, Bird S, Kobel C, Andersen P, et al. HWA Expanded Scopes of Practice program evaluation: Physiotherapists in the Emergency Department sub-project: final report. Wollongong: Australian Health Services Research Institute; 2014.
72.
Gill SD, Stella J. Implementation and performance evaluation of an emergency department primary practitioner physiotherapy service for patients with musculoskeletal conditions. Emerg Med Australas. 2013;25(6):558–564; doi: 10.1111/1742-6723.12134.
73.
Taylor NF, Norman E, Roddy L, Tang C, Pagram A, Hearn K. Primary contact physiotherapy in emergency departments can reduce length of stay for patients with peripheral musculoskeletal injuries compared with secondary contact physiotherapy: a prospective non-randomised controlled trial. Physiotherapy. 2011;97(2):107–114; doi: 10.1016/j.physio.2010.08.011.
74.
Matifat E, Méquignon M, Cunningham C, Blake C, Fennelly O, Desmeules F. Benefits of musculoskeletal physical therapy in emergency departments: a systematic review. Phys Ther. 2019;99(9):1150–1166; doi: 10.1093/ptj/pzz082.
75.
McD Taylor D, Bennett DM, Cameron PA. A paradigm shift in the nature of care provision in emergency departments. Emerg Med J. 2004;21(6):681–684; doi: 10.1136/emj.2004.017640.
76.
Crane J, Delany C. Physiotherapists in emergency departments: responsibilities, accountability and education. Physiotherapy. 2013;99(2):95–100; doi: 10.1016/j.physio.2012.05.003.
77.
Kilner E, Sheppard L. The ‘lone ranger’: a descriptive study of physiotherapy practice in Australian emergency departments. Physiotherapy. 2010;96(3):248–256; doi: 10.1016/j.physio.2010.01.002.
78.
Jibuike OO, Paul-Taylor G, Maulvi S, Richmond P, Fairclough J. Management of soft tissue knee injuries in an accident and emergency department: the effect of the introduction of a physiotherapy practitioner. Emerg Med J. 2003;20(1):37–39; doi: 10.1136/emj.20.1.37.
79.
McClellan CM, Cramp F, Powell J, Benger JR. A randomised trial comparing the clinical effectiveness of different emergency department healthcare professionals in soft tissue injury management. BMJ Open. 2012;2(6):e001092; doi: 10.1136/bmjopen-2012-001092.
80.
McClellan CM, Greenwood R, Benger JR. Effect of an extended scope physiotherapy service on patient satisfaction and the outcome of soft tissue injuries in an adult emergency department. Emerg Med J. 2006;23(5):384–387; doi: 10.1136/emj.2005.029231.
81.
Mir MÓ, O’Sullivan C. Advanced practice physiotherapy in paediatric orthopaedics: innovation and collaboration to improve service delivery. Ir J Med Sci. 2018;187(1):131–140; doi: 10.1007/s11845-017-1611-2.
82.
Mir MO, Cooney C, O’Sullivan C, Blake C, Kelly P, Kiely P, et al. The efficacy of an extended scope physiotherapy clinic in paediatric orthopaedics. J Child Orthop. 2016;10(2):169–175; doi: 10.1007/s11832-016-0725-9.
83.
Lowry V, Bass A, Lavigne P, Léger-St-Jean B, Blanchette D, Perreault K, et al. Physiotherapists’ ability to diagnose and manage shoulder disorders in an outpatient orthopedic clinic: results from a concordance study. J Shoulder Elbow Surg. 2020;29(8):1564–1572; doi: 10.1016/j.jse.2019.11.030.
84.
Fennelly O, Blake C, FitzGerald O, Breen R, Ashton J, Brennan A, et al. Advanced practice physiotherapy-led triage in Irish orthopaedic and rheumatology services: national data audit. BMC Musculoskelet Disord. 2018;19(1):181; doi: 10.1186/s12891-018-2106-7.
85.
Stanhope J, Beaton K, Grimmer-Somers K, Morris J. The role of extended scope physiotherapists in managing patients with inflammatory arthropathies: a systematic review. Open Access Rheumatol. 2012;4:49–55; doi: 10.2147/OARRR.S31465.
86.
Warmington K, Kennedy CA, Lundon K, Soever LJ, Brooks SC, Passalent LA, et al. The patient perspective: arthritis care provided by Advanced Clinician Practitioner in Arthritis Care program-trained clinicians. Open Access Rheumatol. 2015;7:45–53; doi: 10.2147/OARRR.S85783.
87.
Brennen R, Sherburn M, Rosamilia A. Development, implementation and evaluation of an advanced practice in continence and women’s health physiotherapy model of care. Aust N Z J Obstet Gynaecol. 2019;59(3):450–456; doi: 10.1111/ajo.12974.
88.
Marks D, Comans T, Bisset L, Scuffham PA. Substitution of doctors with physiotherapists in the management of common musculoskeletal disorders: a systematic review. Physiotherapy. 2017;103(4):341–351; doi: 10.1016/j.physio.2016.11.006.
89.
Samsson K, Larsson MEH. Physiotherapy screening of patients referred for orthopaedic consultation in primary healthcare – a randomised controlled trial. Man Ther. 2014;19(5):386–391; doi: 10.1016/j.math.2013.10.004.
90.
Samsson KS, Larsson MEH. Physiotherapy triage assessment of patients referred for orthopaedic consultation – long-term follow-up of health-related quality of life, pain-related disability and sick leave. Man Ther. 2015;20(1):38–45; doi: 10.1016/j.math.2014.06.009.
91.
Large KE, Page CJ, Brock K, Dowsey MM, Choong PFM. Physiotherapy-led arthroplasty review clinic: a preliminary outcomes analysis. Aust Health Rev. 2014;38(5):510–516; doi: 10.1071/AH13238.
92.
Daker-White G, Carr AJ, Harvey I, Woolhead G, Bannister G, Nelson I, et al. A randomised controlled trial. Shifting boundaries of doctors and physiotherapists in orthopaedic outpatient departments. J Epidemiol Community Health. 1999;53(10):643–650; doi: 10.1136/jech.53.10.643.
93.
Fennelly O, Blake C, FitzGerald O, Caffrey A, Fletcher L, Smart K, et al. Advanced musculoskeletal physiotherapy practice: the patient journey and experience. Musculoskelet Sci Pract. 2020;45:102077; doi: 10.1016/j.msksp.2019.102077.
94.
Ball STE, Walton K, Hawes S. Do emergency department physiotherapy practitioner’s, emergency nurse practitioners and doctors investigate, treat and refer patients with closed musculoskeletal injuries differently? Emerg Med J. 2007;24(3):185–188; doi: 10.1136/emj.2006.039537.
95.
Passalent LA, Kennedy C, Warmington K, Soever LJ, Lundon K, Shupak R, et al. System integration and clinical utilization of the Advanced Clinician Practitioner in Arthritis Care (ACPAC) Program-trained extended role practitioners in Ontario: a two-year, system-level evaluation. Healthc Policy. 2013;8(4):56–70; doi: 10.12927/hcpol.2013.23396.
96.
Li LC, Westby MD, Sutton E, Thompson M, Sayre EC, Casimiro L. Canadian physiotherapists’ views on certification, specialisation, extended role practice, and entry-level training in rheumatology. BMC Health Serv Res. 2009;9:88; doi: 10.1186/1472-6963-9-88.
97.
Saxon RL, Gray MA, Oprescu FI. Extended roles for allied health professionals: an updated systematic review of the evidence. J Multidiscip Healthc. 2014;7:479–488; doi: 10.2147/JMDH.S66746.
98.
Lundon K, Kennedy C, Rozmovits L, Sinclair L, Shupak R, Warmington K, et al. Evaluation of perceived collaborative behaviour amongst stakeholders and clinicians of a continuing education programme in arthritis care. J Interprof Care. 2013;27(5):401–407; doi: 10.3109/13561820.2013.783559.
99.
State of Victoria, Department of Health and Human Services. Victorian Allied Health Workforce Research Program. Physiotherapy Workforce Report. Melbourne: Victorian Government; 2016. Available from: https://www.health.vic.gov.au/....
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