ArticleMusculoskeletal care2026
First Contact Physiotherapists (FCPs) Referral Practices to Rheumatology: A Scoping Review of the Evidence Base.
Article in Musculoskeletal care, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
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Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundFirst Contact Physiotherapists (FCP) are central to musculoskeletal practice within UK primary care, supporting patients at the earliest point of their healthcare journey. Early recognition and referral of rheumatological conditions are critical aspects of the role, necessitating knowledge, skills and capability.
objectivesTo explore and map existing literature on FCP rheumatology referral practices, identify gaps within the evidence base and inform future research.
designScoping review following Joanna Briggs Institute guidelines.
methodFour bibliographic databases and grey literature were searched for sources published between 2015 and 2025. Study selection and data extraction were completed by the author and additional reviewers. Data were charted in extraction tables and synthesised inductively informing a narrative thematic summary.
results29 sources were included, comprising 8 journal articles, 19 clinical guidelines and 2 frameworks. A paucity of evidence exists across the spectrum of rheumatological conditions, with dominance within axial spondyloarthritis (axSpA). FCPs have been shown to appropriately refer patients with axSpA, thereby reducing the time to diagnosis. Access to investigations is variable, but with ambiguities in interpreting results, clinical correlation is essential. Numerous referral guidelines support diagnosis and referral. Experience, training and effective relationships with rheumatology services were deemed of central importance.
conclusionNo included studies reported safety concerns related to FCP or a contribution to diagnostic delay; however, the limited evidence precludes conclusions on these outcomes. Studies support the value of FCP in rheumatology although they provide limited 'real world' evidence. Future research should evaluate referral practices across the spectrum of rheumatological disorders, the impact of FCP on diagnostic delays and conversion rates, and educational requirements to support rheumatology practice.
trial registrationOpen Science Framework (OSF) https://doi.org/10.17605/OSF.IO/ZV4Y6.
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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.