title: Disease-specific knowledge and clinical skills required by community-based physiotherapists to co-manage patients with rheumatoid arthritis.
abstract: OBJECTIVE
  While strong evidence supports the role of physiotherapy in the co-management of patients with rheumatoid arthritis (RA), it remains unclear what constitutes the essential disease-specific knowledge and clinical skills required by community-based physiotherapists to effectively and safely deliver recommended care. This study aimed to identify essential disease-specific knowledge and skills, link these with evidence from clinical guidelines, and broadly determine the professional development (PD) needs and confidence related to the management of RA among physiotherapists.
  
  
  METHODS
  An international Delphi panel of rheumatologists, physiotherapists, and consumers (n = 27) identified essential disease-specific knowledge and clinical skills over 3 rounds. Physiotherapy-relevant recommendations from high-quality, contemporary clinical guidelines were linked to Delphi responses. Finally, an e-survey of PD needs among registered physiotherapists (n = 285) was undertaken.
  
  
  RESULTS
  Overarching themes identified by the Delphi panel across the RA disease stages included the need for excellent communication, the importance of a multidisciplinary team and early referral, adoption of chronic disease management principles, and disease monitoring. Of the essential Delphi themes, 86.7% aligned with clinical guideline recommendations. Up to 77.5% of physiotherapists reported not being confident in managing patients with RA. Across the range of essential knowledge and skills themes, 45.1-93.5% and 71.1-95.2% of respondents, respectively, indicated they would benefit from or definitely need PD.
  
  
  CONCLUSIONS
  To effectively manage RA, community-based physiotherapists require excellent communication skills and disease-specific knowledge, including understanding the role of the multidisciplinary team and the principles of early referral, chronic disease management, and monitoring. Physiotherapists identified a need for PD to develop these skills.
authors.affiliation: Curtin University and Government of Western Australia, Perth, Western Australia, Australia. A.Briggs@curtin.edu.au
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Briggs
authors.forename: Robyn E
authors.initials: RE
authors.lastname: Fary
authors.forename: Helen
authors.initials: H
authors.lastname: Slater
authors.forename: Peter
authors.initials: P
authors.lastname: Bragge
authors.forename: Jason
authors.initials: J
authors.lastname: Chua
authors.forename: Helen I
authors.initials: HI
authors.lastname: Keen
authors.forename: Madelynn
authors.initials: M
authors.lastname: Chan
mesh_terms: D001172:Arthritis, Rheumatoid / Q000534:rehabilitation*; D002983:Clinical Competence; D019317:Evidence-Based Medicine; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D059825:Physical Therapists; D026741:Physical Therapy Modalities