title: Comparison between primary care physiotherapy education/advice clinics and traditional hospital based physiotherapy treatment: a randomized trial.
abstract: BACKGROUND
  Studies have shown that patients prefer to received physiotherapy services in the primary care setting, but none has made direct comparisons between hospital and primary care based physiotherapy.
  
  
  OBJECTIVE
  This pragmatic randomized trial set out to compare general-practice-based physiotherapy education and advice clinics with traditional physiotherapy treatment in an acute hospital setting.
  
  
  METHODS
  The study involved 130 patients referred to physiotherapy services by 43 general practitioners over a one-year period. Patients were included in the study if they were at work, independent in all activities of daily living and would have routinely been referred to the hospital physiotherapy department for treatment. Patients were randomly allocated to one of two intervention groups: general practice education/advice, or treatment and education/advice at the local hospital. Patients completed a questionnaire prior to their first physiotherapy appointment and again 6 weeks later.
  
  
  RESULTS
  A disappointing number of patients failed to attend either the first or subsequent appointments. The post-intervention scores revealed improvements in patients' problems, with the advice group exhibiting a slightly better outcome than the hospital group, as measured by the Nottingham health profile, the anxiety component of the hospital anxiety and depression rating scale, pain and problem size visual analogue scales, and measures of patient satisfaction. Advice group patients also had less attendances than the hospital treatment group. The general practitioners surveyed commented favourably on the advice clinics.
  
  
  CONCLUSIONS
  The findings of this study justify the concept of general-practice-based physiotherapy education and advice clinics.
authors.affiliation: Department of Medical Statistics and Computing, University of Southampton.
authors.forename: C
authors.initials: C
authors.lastname: Worsfold
authors.forename: J
authors.initials: J
authors.lastname: Langridge
authors.forename: A
authors.initials: A
authors.lastname: Spalding
authors.forename: M A
authors.initials: MA
authors.lastname: Mullee
mesh_terms: D000328:Adult; D004739:England; D005260:Female; D006266:Health Education; D006801:Humans; D008297:Male; D008875:Middle Aged; D010814:Physical Therapy Department, Hospital; D026741:Physical Therapy Modalities; D011320:Primary Health Care