title: The acceptability to patients of PhysioDirect telephone assessment and advice services; a qualitative interview study.
abstract: BACKGROUND
  In response to long waiting lists and problems with access to primary care physiotherapy, several Primary Care Trusts (PCTs) (now Clinical Commissioning Groups CCGs) developed physiotherapy-led telephone assessment and treatment services. The Medical Research Council (MRC) funded PhysioDirect trial was a randomised control trial (RCT) in four PCTs, with a total of 2252 patients that compared this approach with usual physiotherapy care. This nested qualitative study aimed to explore the acceptability of the PhysioDirect telephone assessment and advice service to patients with musculoskeletal conditions.
  
  
  METHODS
  We conducted 57 semi-structured interviews with adults from 4 PCTs who were referred from general practice to physiotherapy with musculoskeletal conditions and were participating in the PhysioDirect trial. The Framework method was used to analyse the qualitative data.
  
  
  RESULTS
  The PhysioDirect service was largely viewed as acceptable although some saw it as a first step to subsequent face-to-face physiotherapy. Most participants found accessing the PhysioDirect service straightforward and smooth, and they valued the faster access to physiotherapy advice offered by the telephone service. Participants generally viewed both the PhysioDirect service and the physiotherapists providing the service as helpful. Participants' preferences and priorities for treatment defined the acceptable features of PhysioDirect but the acceptable features were traded off against less acceptable features. Some participants felt that the PhysioDirect service was impersonal and impaired the development of a good relationship with their physiotherapist, which made the service feel remote and less valuable.
  
  
  CONCLUSIONS
  The PhysioDirect service was broadly acceptable to participants since it provided faster access to physiotherapy advice for their musculoskeletal conditions. Participants felt that it is best placed as one method of accessing physiotherapy services, in addition to, rather than as a replacement for, more traditional face-to-face physiotherapy assessment and treatment.
authors.affiliation: Faculty of Health & Applied Sciences, University of the West of England, Glenside Campus, Blackberry Hill, Bristol, BS16 1DD, UK. Jen.pearson@uwe.ac.uk.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Pearson
authors.affiliation: Arthritis Research UK Primary Care Centre Research Institute for Primary Care and Health Sciences, Keele University, Keele, Staffs, ST5 5BG, UK.
authors.forename: Jane
authors.initials: J
authors.lastname: Richardson
authors.affiliation: School of Social Policy, Sociology and Social Research, University of Kent, Cornwallis North East, Canterbury, Kent, CT2 7NF, UK.
authors.forename: Michael
authors.initials: M
authors.lastname: Calnan
authors.affiliation: NIHR School for Primary Care Research, School of Social and Community Medicine, University of Bristol Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK.
authors.forename: Chris
authors.initials: C
authors.lastname: Salisbury
authors.affiliation: Arthritis Research UK Primary Care Centre Research Institute for Primary Care and Health Sciences, Keele University, Keele, Staffs, ST5 5BG, UK.
authors.forename: Nadine E
authors.initials: NE
authors.lastname: Foster
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005194:Family Practice; D005260:Female; D006379:Helping Behavior; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000175:diagnosis / Q000628:therapy; D017060:Patient Satisfaction; D026741:Physical Therapy Modalities; D011320:Primary Health Care; D036301:Qualitative Research; D013689:Telephone; D014850:Waiting Lists; D055815:Young Adult
keywords: Interview; Patient experience; Physiotherapy; Qualitative study; Service delivery