Impacts of advanced physiotherapy: A narrative literature review

Abstract

Changes to healthcare design and delivery involving advanced physiotherapy roles may help health systems to meet challenges imposed by ageing populations, long-term conditions and unsustainable healthcare costs. This narrative literature review examined recent peer-reviewed literature (2010–2017), including primary studies and systematic reviews, that investigated the impact of advanced physiotherapy on healthcare efficacy, efficiency, service design or perceptions (consumers or health professionals) of these advanced roles. Thirty-five studies were included that investigated advanced physiotherapy roles in primary care, emergency department, orthopaedic outpatient and rheumatology clinic contexts. Implementation of these roles was found to reduce waiting times for appointments, reduce length of stay, improve access to care, reduce other clinicians’ workload in primary care and emergency departments, streamline orthopaedic surgeons’ caseload, and improve patient satisfaction. Some studies observed patient recovery outcomes following advanced practice physiotherapist care, but none compared these to existing models of care. In addition, few studies explored non musculoskeletal physiotherapy fields or the New Zealand context, and no studies investigated the impact on consumer choice. More clearly defined and consistent use of advanced physiotherapy roles within the literature would enable a better understanding of the potential impact on health care. Overall, evidence suggested that advanced physiotherapy roles may provide benefits to the public and health system when implemented in innovative, interdisciplinary and non-traditional ways.