Patients', physiotherapists' and other stakeholders' experiences and perceptions about supported home physiotherapy for people with musculoskeletal conditions: a qualitative study

Hannah G Withers; Hueiming Liu; Joanne V Glinsky; Jackie Chu; Matthew D Jennings; Alison J Hayes; Ian Starkey; Blake A Palmer; Lukas Szymanek; Jackson J Cruwys; David Wong; Kitty Duong; Anne Barnett; Matthew Tindall; Barbara Lucas; Tara E Lambert; Deborah Taylor; Catherine Sherrington; Manuela Ferreira; Christopher Maher; Joshua Zadro; Kerry Hart; Wendy Hodge; Lisa A Harvey

doi:10.1016/j.physio.2024.01.006

Patients', physiotherapists' and other stakeholders' experiences and perceptions about supported home physiotherapy for people with musculoskeletal conditions: a qualitative study

Physiotherapy. 2024 Sep:124:143-153. doi: 10.1016/j.physio.2024.01.006. Epub 2024 Feb 1.

Authors

Hannah G Withers¹, Hueiming Liu², Joanne V Glinsky³, Jackie Chu⁴, Matthew D Jennings⁵, Alison J Hayes⁶, Ian Starkey⁷, Blake A Palmer⁸, Lukas Szymanek⁹, Jackson J Cruwys¹⁰, David Wong¹¹, Kitty Duong¹², Anne Barnett¹³, Matthew Tindall¹⁴, Barbara Lucas¹⁵, Tara E Lambert¹⁶, Deborah Taylor¹⁷, Catherine Sherrington¹⁸, Manuela Ferreira¹⁹, Christopher Maher²⁰, Joshua Zadro²¹, Kerry Hart²², Wendy Hodge²³, Lisa A Harvey²⁴

Affiliations

¹ John Walsh Centre for Rehabilitation Research, Kolling Institute, Faculty of Medicine and Health, University of Sydney, C/O Royal North Shore Hospital, Pacific Highway, St Leonards, NSW 2065, Australia. Electronic address: [email protected].
² The George Institute for Global Health, University of New South Wales, Level 5, 1 King St, Newtown, NSW 2042, Australia. Electronic address: [email protected].
³ John Walsh Centre for Rehabilitation Research, Kolling Institute, Faculty of Medicine and Health, University of Sydney, C/O Royal North Shore Hospital, Pacific Highway, St Leonards, NSW 2065, Australia. Electronic address: [email protected].
⁴ John Walsh Centre for Rehabilitation Research, Kolling Institute, Faculty of Medicine and Health, University of Sydney, C/O Royal North Shore Hospital, Pacific Highway, St Leonards, NSW 2065, Australia. Electronic address: [email protected].
⁵ Allied Health Services, Liverpool Hospital, Locked Bag 7103, Liverpool, NSW 1871, Australia. Electronic address: [email protected].
⁶ School of Public Health, Faculty of Medicine and Health, The University of Sydney, NSW 2006, Australia. Electronic address: [email protected].
⁷ Blacktown and Mt Druitt Hospitals, PO Box 792, Seven Hills, NSW 1730, Australia. Electronic address: [email protected].
⁸ Blacktown and Mt Druitt Hospitals, PO Box 792, Seven Hills, NSW 1730, Australia. Electronic address: [email protected].
⁹ Camden and Campbelltown Hospital, Campbelltown Hospital, Therry Road, Campbelltown, NSW 2560, Australia. Electronic address: [email protected].
¹⁰ Camden and Campbelltown Hospital, Campbelltown Hospital, Therry Road, Campbelltown, NSW 2560, Australia. Electronic address: [email protected].
¹¹ Liverpool Hospital, Level 2 Health Services Building, Corner Campbell and Goulbourn Street, Liverpool, NSW 2170, Australia. Electronic address: [email protected].
¹² Liverpool Hospital, Level 2 Health Services Building, Corner Campbell and Goulbourn Street, Liverpool, NSW 2170, Australia. Electronic address: [email protected].
¹³ Bankstown-Lidcombe Hospital, Locked Mail Bag 1600, Bankstown, NSW 2200, Australia. Electronic address: [email protected].
¹⁴ Bankstown-Lidcombe Hospital, Locked Mail Bag 1600, Bankstown, NSW 2200, Australia. Electronic address: [email protected].
¹⁵ Royal North Shore Hospital, Building 30, Level 2, Pacific Highway, St Leonards, NSW 2065, Australia. Electronic address: [email protected].
¹⁶ Royal North Shore Hospital, Building 30, Level 2, Pacific Highway, St Leonards, NSW 2065, Australia. Electronic address: [email protected].
¹⁷ Physiotherapy Department RNSH, Building 30, Level 2, Pacific Highway, St Leonards, NSW 2065, Australia. Electronic address: [email protected].
¹⁸ The University of Sydney, Institute for Musculoskeletal Health, King George V Building, Level 10 Missenden Road, Camperdown NSW 2050, Australia. Electronic address: [email protected].
¹⁹ The University of Sydney, Sydney Musculoskeletal Health, School of Health Sciences, Royal North Shore Hospital, Level 10 The Kolling Building, St Leonards, NSW 2065, Australia. Electronic address: [email protected].
²⁰ The University of Sydney, Institute for Musculoskeletal Health, King George V Building, Level 10 Missenden Road, Camperdown NSW 2050, Australia. Electronic address: [email protected].
²¹ The University of Sydney, Institute for Musculoskeletal Health, King George V Building, Level 10 Missenden Road, Camperdown NSW 2050, Australia. Electronic address: [email protected].
²² ARTD Consultants, Level 4, 352 Kent St, Sydney, NSW 2000, Australia. Electronic address: [email protected].
²³ ARTD Consultants, Level 4, 352 Kent St, Sydney, NSW 2000, Australia. Electronic address: [email protected].
²⁴ John Walsh Centre for Rehabilitation Research, Kolling Institute, Faculty of Medicine and Health, University of Sydney, C/O Royal North Shore Hospital, Pacific Highway, St Leonards, NSW 2065, Australia. Electronic address: [email protected].

PMID: 38901217
DOI: 10.1016/j.physio.2024.01.006

Abstract

Objectives: Exercise, support and advice are the key treatment strategies of musculoskeletal problems. The aims of this study were to determine patients', physiotherapists', and other stakeholders' perspectives about supported home physiotherapy for the management of musculoskeletal problems and to identify the barriers and facilitators to rolling out this model of physiotherapy service delivery.

Methods: This study was conducted as part of a process evaluation run alongside a large trial designed to determine whether supported home physiotherapy is as good or better than a course of in-person physiotherapy. Forty interviews were conducted with 20 trial participants, 15 physiotherapists, and 5 other stakeholders. The interviews were semi-structured and based on interview guides. Each interview was transcribed and a three-tiered coding tree was developed.

Results: Six key themes were identified. Supported home physiotherapy (i) is convenient for some patients, (ii) does not always align with patients' and therapists' expectations about treatment (iii) is suitable for some but not all, (iv) can reduce personal connection and accountability, (v) has implications for physiotherapists' workloads, and (vi) has barriers and facilitators to future implementation.

Conclusions: Findings suggest that patients are far more accepting of supported home physiotherapy than physiotherapists assume. This model of service delivery could be rolled out to improve access to physiotherapy and to provide a convenient and effective way of delivering physiotherapy to some patients with musculoskeletal conditions if our trial results indicate that supported home physiotherapy is as good or better than in-person physiotherapy.

Clinical trial registry number: ACTRN12619000065190 CONTRIBUTIONS OF THIS PAPER.

Keywords: Covid-19; Musculoskeletal diseases; Physical therapists; Physical therapy modalities.

MeSH terms

Adult
Aged
Attitude of Health Personnel
Female
Home Care Services*
Humans
Interviews as Topic
Male
Middle Aged
Musculoskeletal Diseases* / rehabilitation
Physical Therapists*
Physical Therapy Modalities*
Qualitative Research*

Associated data

ANZCTR/12619000065190