ArticleBMC musculoskeletal disorders2018
Advanced practice physiotherapy-led triage in Irish orthopaedic and rheumatology services: national data audit.
Article in BMC musculoskeletal disorders, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it, 57 citations in OpenAlex.
- Effects on health and process outcomes of physiotherapist-led orthopaedic triage for patients with musculoskeletal disorders: a systematic review of comparative studies.BMC musculoskeletal disorders · 2020Pooled it
- First Contact Physiotherapists (FCPs) Referral Practices to Rheumatology: A Scoping Review of the Evidence Base.Musculoskeletal care · 2026Article
- Patients and Advanced Practice Physiotherapists' Experiences and Perceptions in a Specialized Spine Model of Care: A Qualitative Study.Physiotherapy Canada. Physiotherapie Canada · 2026Article
- Joint Efforts: A Review of Large Joint and Bursa Steroid Injections and Aspirations by Primary Care Physicians.Journal of general internal medicine · 2025Review
- Evaluation of Outpatient Procedures Simulation Curriculum for Internal Medicine Residents.Journal of general internal medicine · 2025Article
- Using Best-Worst Scaling Survey to Investigate the Relative Importance of Attributes Associated with Public Hospital Outpatient Appointments.The patient · 2025Article
- Informing Implementation of a National Integrated Clinical Pathway for Low Back Pain in Ireland: A Pre-Implementation Qualitative Study With General Practitioners.Musculoskeletal care · 2025Article
- Operationalising routinely collected patient data in research to further the pursuit of social justice and health equity: a team-based scoping review.BMC medical research methodology · 2025Article
- Article
- An evaluation of the effectiveness of an advanced practice physiotherapist in the emergency department setting in Ireland.Irish journal of medical science · 2024Article
- First contact physiotherapists: are they able to reduce the burden on rheumatology services? A critical review of the evidence base.Rheumatology advances in practice · 2024Review
- Using Lean Six Sigma in a Private Hospital Setting to Reduce Trauma Orthopedic Patient Waiting Times and Associated Administrative and Consultant Caseload.Healthcare (Basel, Switzerland) · 2023Article
- "You're stuck in the middle here": a qualitative study of GPs' experiences of managing knee pain attributed to a degenerative meniscal tear.BMC primary care · 2023Article
- Was the impact of COVID-19 on a spinal triage service as significant as expected? A retrospective service evaluation: Results and evaluation.Musculoskeletal care · 2022Article
- Clinician's Commentary on Crawford et al.Physiotherapy Canada. Physiotherapie Canada · 2022Article
- A physiotherapy triage service for orthopaedic upper limb service: an effective way to reduce clinic visits and identify patients for operative intervention.Irish journal of medical science · 2022Observational
- Patient gender does not influence referral to an orthopaedic surgeon by advanced practice orthopaedic providers: a prospective observational study in Canada.BMC health services research · 2021Observational
- Inter-professional agreement and collaboration between extended scope physiotherapists and orthopaedic surgeons in an orthopaedic outpatient shoulder clinic - a mixed methods study.BMC musculoskeletal disorders · 2021Article
- Patient, Rheumatologist and Therapist Perspectives on the Implementation of an Allied Health Rheumatology Triage (AHRT) Initiative in Ontario Rheumatology Clinics.Pragmatic and observational research · 2020Article
- Physiotherapist-Led Triage at a Rheumatology-Based Musculoskeletal Assessment Clinic: an 18-Month Service Evaluation of Activity and Outcomes.ACR open rheumatology · 2019Article
Corrections and comments
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Authors and funding
9 authors at 6 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMany people with musculoskeletal (MSK) disorders wait several months or years for Consultant Doctor appointments, despite often not requiring medical or surgical interventions. To allow earlier patient access to orthopaedic and rheumatology services in Ireland, Advanced Practice Physiotherapists (APPs) were introduced at 16 major acute hospitals. This study performed the first national evaluation of APP triage services.
methodThroughout 2014, APPs (n = 22) entered clinical data on a national database. Analysis of these data using descriptive statistics determined patient wait times, Consultant Doctor involvement in clinical decisions, and patient clinical outcomes. Chi square tests were used to compare patient clinical outcomes across orthopaedic and rheumatology clinics. A pilot study at one site identified re-referral rates to orthopaedic/rheumatology services of patients managed by the APPs.
resultsIn one year, 13,981 new patients accessed specialist orthopaedic and rheumatology consultations via the APP. Median wait time for an appointment was 5.6 months. Patients most commonly presented with knee (23%), lower back (22%) and shoulder (15%) disorders. APPs made autonomous clinical decisions regarding patient management at 77% of appointments, and managed patient care pathways without onward referral to Consultant Doctors in more than 80% of cases. Other onward clinical pathways recommended by APPs were: physiotherapy referrals (42%); clinical investigations (29%); injections administered (4%); and surgical listing (2%). Of those managed by the APP, the pilot study identified that only 6.5% of patients were re-referred within one year.
conclusionThis national evaluation of APP services demonstrated that the majority of patients assessed by an APP did not require onward referral for a Consultant Doctor appointment. Therefore, patients gained earlier access to orthopaedic and rheumatology consultations in secondary care, with most patients conservatively managed.
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