A telephone assessment and advice service within an ED physiotherapy clinic: a single-site quality improvement cohort study.
Marie Kelly, Anna Higgins, Adrian Murphy and 1 others
PMID 33550990WHAT IT FOUND
In a self-selected emergency department physiotherapy cohort, telephone assessment and advice had a median wait time of 6 days versus 35 days.
Non-attendance was 10% and 22%, and the study did not show a lower rate. Satisfaction and global improvement did not differ.
Key findings
01The telephone assessment and advice group had a median wait time of 6 days (3 to 8 days) to first physiotherapy contact, compared with a median 35 days (19 to 39 days) for usual care.
02Non-attendance was 10% in the telephone group and 22% in the usual care group, but the difference was not significant.
03Overall satisfaction and global improvement scores did not differ significantly between groups.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
Patients chose the telephone or face-to-face pathway, so the groups were not randomised and may have differed before treatment. The paper states a high risk of confounding bias and an imbalance between groups, with 17 usual-care participants in Table 1. The analysed telephone group is unclear: the flow reports 33 eligible participants who contacted the telephone service, while Table 1 lists 86 telephone-service participants. 60% (55/91) of those who opted for telephone did not contact the service, and reasons for non-contact or non-attendance were not captured. No a priori power calculation was performed. The telephone pathway included assessment, advice, posted exercise material and follow-up, so the contribution of any single component cannot be separated. Clinical outcome was a single seven-point global improvement question, not a disease-specific measure. The study was single-site and involved a broad range of musculoskeletal presentations, so results may not apply to other services or conditions. The telephone pathway did not show a significant difference in non-attendance, satisfaction or global improvement.
The easy way to misread this
Do not read the shorter wait time or the 10% and 22% non-attendance rates as proof that the telephone service caused them. Patients chose their pathway, and the non-attendance difference was not significant.