Patient Choice After Referral to Physical Therapy for Lower Back Pain and Knee Osteoarthritis.
Jason A Sharpe, Abigail Shapiro, Adam Goode and 4 others
PMID 36968161WHAT IT FOUND
Veterans referred to physical therapy for back pain or knee osteoarthritis described appointment confusion, long waits, travel or work barriers, and doubts that physical therapists could diagnose or provide effective treatment as barriers to starting care.
Key findings
01Patients reported confusion about referrals, scheduling, and call-center processes, especially when many steps were involved.
02Patients often had positive views of physical therapy but limited knowledge, including beliefs that physical therapists could not diagnose lower back pain or knee osteoarthritis.
03Long waits, travel distance, and work schedules were reported barriers, while trusted provider discussion was described as increasing patients' ability to initiate care.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study included only Veterans using the Veterans Health Administration, so its findings may not apply to other health systems or civilian patients. The sample had limited sex diversity, and the coders' backgrounds may have shaped the interviews and themes. Some participants did not remember receiving a referral or attending physical therapy, even when chart review showed telephone or video care, so group assignment relied partly on recall and records. The study did not involve Veterans in designing the research.
The easy way to misread this
Do not conclude that patient education or telehealth will increase physical therapy use. This qualitative study reports experiences and barriers, not proof that any intervention works.