Trial reportBMC musculoskeletal disorders2019
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.
Trial report in BMC musculoskeletal disorders, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 28 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
The Effects of Triaging Patients With Musculoskeletal Disorders Directly to Physiotherapists at Primary Health Care Clinics: a Pilot Study and Randomized Controlled Trial.
Video-based First-contact Consultation With a Physiotherapist in Primary Care for Patients With Musculoskeletal Symptoms
Who cites it
28 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Systematic review of direct access physiotherapy for musculoskeletal conditions in primary care: consequences for general practitioner workload, resource use, and organisation of care.BMC primary care · 2026Pooled it
- Economic evaluation of advanced practice physiotherapy models of care: a systematic review with meta-analyses.BMC health services research · 2021Pooled it
- Physiotherapists as first-contact practitioners for patients with low back pain in French primary care: a pragmatic cluster randomised controlled trial.BMC health services research · 2024Trial
- Effect of osteopathic techniques on human resting muscle tone in healthy subjects using myotonometry: a factorial randomized trial.Scientific reports · 2022Trial
- Physiotherapist or physician as primary assessor for patients with suspected knee osteoarthritis in primary care - a cost-effectiveness analysis of a pragmatic trial.BMC musculoskeletal disorders · 2022Trial
- Treatment trajectories among patients with musculoskeletal disorders in Norway - a register-based cohort study over 2 years.Scandinavian journal of primary health care · 2026Article
- The value of integrating physical therapists into primary care, including patient outcomes and health care costs: a scoping review.Physical therapy · 2026Article
- Cost savings of outpatient parenteral antimicrobial therapy using a digital infusion pump.JAC-antimicrobial resistance · 2026Article
- Prevalence of musculoskeletal disorders and physiotherapy utilization in primary care - a registry-based study in Sweden.BMC primary care · 2025Article
- Economic Evaluation in Physiotherapy or How to Get the Best Value for Money.Physiotherapy Canada. Physiotherapie Canada · 2025Article
- Reducing strain on primary healthcare systems through innovative models of care: the impact of direct access physiotherapy for musculoskeletal conditions-an interrupted time series analysis.Family medicine and community health · 2024Article
- The educational pathway to Advanced Practice for the physiotherapist: Protocol for a systematic mixed studies review.PloS one · 2024Article
- Effectiveness and Consequences of Direct Access in Physiotherapy: A Systematic Review.Journal of clinical medicine · 2023Review
- Musculoskeletal Pain: Current and Future Directions of Physical Therapy Practice.Archives of rehabilitation research and clinical translation · 2023Article
- Patient Choice After Referral to Physical Therapy for Lower Back Pain and Knee Osteoarthritis.Archives of rehabilitation research and clinical translation · 2023Article
- Cost-effectiveness of specialised manual therapyTherapeutic advances in musculoskeletal disease · 2023Article
- Article
- Usability Testing of a Digital Assessment Routing Tool for Musculoskeletal Disorders: Iterative, Convergent Mixed Methods Study.Journal of medical Internet research · 2022Article
- Correlation between self-efficacy, fear of movement, empowerment, enablement, and number of visits to physiotherapist among patients with musculoskeletal disorders in primary health care: a feasibility study.Pilot and feasibility studies · 2022Article
- Reply to Moretti et al. Would Moving Forward Mean Going Back? Comment on "Maselli et al. Direct Access to Physical Therapy: Should Italy Move Forward?International journal of environmental research and public health · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
Abstract
backgroundA model for triaging patients in primary care to provide immediate contact with the most appropriate profession to treat the condition in question has been developed and implemented in parts of Sweden. Direct triaging of patients with musculoskeletal disorders (MSD) to physiotherapists at primary healthcare centres has been proposed as an alternative to initial assessment by general practitioners (GPs) and has been shown to have many positive effects. The aim of this study was to evaluate the cost-effectiveness from the societal perspective of this new care-pathway through primary care regarding triaging patients with MSD to initial assessment by physiotherapists compared to standard practice with initial GP assessment.
methodsNurse-assessed patients with MSD (N = 55) were randomised to initial assessment and treatment with either physiotherapists or GPs and were followed for 1 year regarding health-related quality of life, utilization of healthcare resources and absence from work for MSD. Quality-adjusted life-years (QALYs) were calculated based on EQ5D measured at 5 time-points. Costs for healthcare resources and production loss were compiled. Incremental cost-effectiveness ratios (ICERS) were calculated. Multiple imputation was used to compensate for missing values and bootstrapping to handle uncertainty. A cost-effectiveness plane and a cost-effectiveness acceptability curve were construed to describe the results.
resultsThe group who were allocated to initial assessment by physiotherapists had slightly larger gains in QALYs at lower total costs. At a willingness-to-pay threshold of 20,000 €, the likelihood that the intervention was cost-effective from a societal perspective including production loss due to MSD was 85% increasing to 93% at higher thresholds. When only healthcare costs were considered, triaging to physiotherapists was still less costly in relation to health improvements than standard praxis.
conclusionFrom the societal perspective, this small study indicated that triaging directly to physiotherapists in primary care has a high likelihood of being cost-effective. However, further larger randomised trials will be necessary to corroborate these findings.
trial registrationClinicalTrials.gov NCT02218749 . Registered August 18, 2014.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.