title: Physiotherapy triage assessment of patients referred for orthopaedic consultation - Long-term follow-up of health-related quality of life, pain-related disability and sick leave.
abstract: BACKGROUND
  The literature indicates that physiotherapy triage assessment can be efficient for patients referred for orthopaedic consultation, however long-term follow up of patient reported outcome measures are not available.
  
  
  OBJECTIVE
  To report a long-term evaluation of patient-reported health-related quality of life, pain-related disability, and sick leave after a physiotherapy triage assessment of patients referred for orthopaedic consultation compared with standard practice.
  
  
  METHODS
  Patients referred for orthopaedic consultation (n = 208) were randomised to physiotherapy triage assessment or standard practice. The randomised cohort was analysed on an intention-to-treat (ITT) basis. The patient reported outcome measures EuroQol VAS (self-reported health-state), EuroQol 5D-3L (EQ-5D) and Pain Disability Index (PDI) were assessed at baseline and after 3, 6 and 12 months. EQ VAS was analysed using a repeated measure ANOVA. PDI and EQ-5D were analysed using a marginal logistic regression model. Sick leave was analysed for the 12 months following consultation using a Mann-Whitney U-test.
  
  
  RESULTS
  The patients rated a significantly better health-state at 3 after physiotherapy triage assessment [mean difference -5.7 (95% CI -11.1; -0.2); p = 0.04]. There were no other statistically significant differences in perceived health-related quality of life or pain related disability between the groups at any of the follow-ups, or sick leave.
  
  
  CONCLUSIONS
  This study reports that the long-term follow up of the patient related outcome measures health-related quality of life, pain-related disability and sick leave after physiotherapy triage assessment did not differ from standard practice, indicating the possible benefits of implementation of this model of care.
authors.affiliation: Department of Clinical Neuroscience and Rehabilitation, The Sahlgrenska Academy, Gothenburg University, Box 430, 405 30 Gothenburg, Sweden; Närhalsan Tjörn Rehabilitation Clinic, Primary Healthcare, Region Västra Götaland, Syster Ebbas väg 1, 471 94 Kållekärr, Sweden. Electronic address: karin.samsson@vgregion.se.
authors.forename: Karin S
authors.initials: KS
authors.lastname: Samsson
authors.affiliation: Department of Clinical Neuroscience and Rehabilitation, The Sahlgrenska Academy, Gothenburg University, Box 430, 405 30 Gothenburg, Sweden; Närhalsan Research and Development, Primary Healthcare, Region Västra Götaland, Kungsgatan 12, level 6 411 18 Gothenburg, Sweden.
authors.forename: Maria E H
authors.initials: ME
authors.lastname: Larsson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000628:therapy*; D019637:Orthopedic Procedures; D010147:Pain Measurement; D026741:Physical Therapy Modalities; D011788:Quality of Life; D018582:Sick Leave / Q000706:statistics & numerical data*; D013548:Sweden; D016896:Treatment Outcome; D014218:Triage
keywords: EQ-5D; PDI; Primary care; Randomised controlled trial