Direct Access to Physiotherapy in the Context of Primary Care in Spain: A Review Study
DOI:
https://doi.org/10.48047/jvv6vk79Keywords:
Direct Access; Physiotherapy; Primary Health Care.Abstract
Background and Objective:
Several literature reviews have addressed direct access to physiotherapy (DAP), but none have focused specifically on the Spanish context. Therefore, the aim of this study is to describe the available information in scientific articles and news reports regarding DAP within the scope of primary care in Spain.
Materials and Methods:
A review of scientific literature and news articles was conducted up to August 2023. The search was carried out using Google (general and academic), PubMed, Scopus, Dialnet, and the websites of the Official Colleges of Physiotherapy in Spain.
Results:
Four scientific articles and ten news reports (published by the Official Colleges of Physiotherapy of Catalonia, Galicia, Navarre, Madrid, Extremadura, and Castile and León) were identified, all published since 2012, with a noticeable increase in news reports from 2018 onwards.
Conclusions:
Scientific literature on DAP in the context of Primary Care in Spain is very limited. However, a recent increase in the number of news reports has been observed.
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References
Ministerio de Sanidad. Ministerio de Sanidad - Profesionales - CS-AtencionPrimaria [Internet]. 2022. Disponible en: https://www.sanidad.gob.es/profesionales/prestacionesSanitarias/CarteraDeServicios/ContenidoCS/2AtencionPrimaria/home.htm
Alma-ata D DE. The Pan American Health Organization Promoting Health in the Americas. 2012; Disponible en: http://www.paho.org/spanish/dd/pin/alma-ata_declaracion.htm
OMS. Atención primaria de salud [Internet]. 2021. Disponible en : https://www.who.int/es/news-room/fact-sheets/detail/primary-health-care
Martínez-Lentisco M. Derivación directa al Servicio de Fisioterapia en Atención Primaria: beneficios en la demora. Estudio transversal tras siete años de implementación. Cuest fisioter. 2020;49:89–98.
McColl MA, Shortt S, Godwin M, Smith K, Rowe K, O’Brien P, et al. Models for integrating rehabilitation and primary care: a scoping study. Arch Phys Med Rehabil. 2009;90:1523–31.
McMahon S, O’Donoghue G, Doody C, O’Neill G, Barrett T, Cusack T. Standing on the precipice: Evaluating final-year physiotherapy students’ perspectives of their curriculum as preparation for primary health care practice. Physiotherapy Canada. 2016;68:188–96.
Mostert-Wentzel K, Frantz J, Van Rooijen AJ. A model for community physiotherapy from the perspective of newly graduated physiotherapists as a guide to curriculum revision. Afr J Health Prof Educ. 2013;5:19.
Gobierno de España. BOE.es - BOE-A-2006-16212 Real Decreto 1030/2006, de 15 de septiembre, por el que se establece la cartera de servicios comunes del Sistema Nacional de Salud y el procedimiento para su actualización. [Internet]. 2006. Disponible en: https://www.boe.es/buscar/act.php?id=BOE-A-2006-16212
Generalitat de Catalunya. Departament de Salut. Programa d’incorporació de fisioterapeutes per la promoció del funcionament i la prevenció de la discapacitat a l’atenció primària i comunitària. Departament de Salut [Internet]. 2022. Disponible en: https://salutweb.gencat.cat/ca/el_departament/ambits-estrategics/atencio-primaria-comunitaria/projectes/programa-incorporacio-fisioterapeutes/
Bury TJ, Stokes EK. Direct access and patient/client self-referral to physiotherapy: A review of contemporary practice within the European Union. Physiotherapy. 2013;99:285–91.
Bury TJ, Stokes EK. A global view of direct access and patient self-referral to physical therapy: implications for the profession. Phys Ther. 2013;93:449–59. 12. Remondière R, Durafourg M-P. Direct access to physiotherapy: the case of France. Sante Publique. 2014;26:669-77. https://doi.org/10.3917/spub.145.0669
Middleton K. Give patients direct access to physiotherapy: They want it, and it would benefit GPS too. BMJ (Online). 2016;352. 14. Wagemans R, Belliot A. Direct access to physiotherapy in France: An opinion survey of general medical interns. Exploratory study. Kinésithérapie, la Revue. 2022; 22: 28-36. https://doi.org/10.1016/j.kine.2021.06.006
Long J. European region of the WCPT statement on physiotherapy in primary care. Primary Health Care Research & Development. 2019. 20(e147): 1–4. doi: 10.1017/S1463423619000811
Gallotti M, Campagnola B, Cocchieri A,Mourad F, Heick JD, Maselli F. Effectiveness and Consequences of Direct Access in Physiotherapy: A Systematic Review. J Clin Med. 2023, 12. doi: 10.3390/jcm12185832
Hon S, Ritter R, Allen DD. Cost-Effectiveness and Outcomes of Direct Access to Physical Therapy for Musculoskeletal Disorders Compared to Physician-First Access in the United States: Systematic Review and Meta-Analysis. Physical Therapy. 2021, 101.https://doi.org/10.1093/PTJ/PZAA201
Babatunde OO, Bishop A, Cottrell E, Jordan JL, Corp N, Humphries K, Hadley-Barrows T, Huntley A, van der Windt DA. A systematic review and evidence synthesis of non-medical triage, self-referral and direct access services for patients with musculoskeletal pain. PloS One. 2020, 15.https://doi.org/10.1371/JOURNAL.PONE.0235364
Demont A, Bourmaud A, Kechichian A, Desmeules F. The impact of direct access physiotherapy compared to primary care physician led usual care for patients with musculoskeletal disorders: a systematic review of the literature. Disability and Rehabilitation. 2021, 43: 1637–48. https://doi.org/10.1080/09638288.2019.1674388
Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. Declaración PRISMA 2020: una guía actualizada para la publicación de revisiones sistemáticas. Revista Española de Cardiología. 2021, 74: 790-9. https://doi.org/10.1016/j.recesp.2021.06.016
Juan García FJ. Acceso directo a fisioterapia, terapia ocupacional y logopedia. Vol. 46, Rehabilitación. 2012. 254–5.
Souto Camba S. Autonomía profesional y acceso directo en fisioterapia. Fisioterapia . 2013;35:89–91.
Capó-Juan MA, Callejero-Guillén A. Fisioterapia y sociedad. Acercándonos a las necesidades reales. Fisioterapia. 2018; 40:278-9. https://doi.org/10.1016/j.ft.2018.05.002
Fisioterapeutas de toda España se dan cita en Badajoz para reclamar mejoras y consenso en la atención primaria - COFEXT [Internet]. 2018. Disponible en: https://cofext.org/fisioterapetas-reclaman-mejoras-atencion-primaria/
Colegio Oficial de Fisioterapeutas de Galicia [Internet]. 2022. Disponible en: https://www.cofiga.org/ciudadanos/sala-de-prensa/noticias/1340/Galicia-comunidade-autonoma-pioneira-en-ofrecer-a-poboacion-acceso-directo-a-Fisioterapia-en-Atencion-Primaria
Colegio Oficial de Fisioterapeutas de Galicia [Internet]. 2019. Disponible en: https://www.cofiga.org/ciudadanos/sala-de-prensa/noticias/1052/Reivindicando-o-acceso-directo-e-a-plena-autonomia-do-fisioterapeuta-como-profesional-sanitario-de-referencia-na-atencion-socio-sanitaria-da-cronicidade-e-a-dependencia-derivadas-do-progresivo-envellecemento-da-poboacion
Colegio Oficial de Fisioterapeutas de Navarra [Internet]. 2022. Disponible en: https://www.cofn.net/es/la-fisioterapia-es-esencial-en-atencion-primaria-para-tratar-el-dolor-cronico
Colegio Oficial de Fisioterapeutas de Navarra [Internet]. 2022. Disponible en: https://www.cofn.net/es/la-fisioterapia-es-esencial-en-atencion-primaria-para-tratar-el-dolor-cronico
Salut anuncia que tots els CAP tindran fisioterapeuta el 2023 [Internet]. 2022. Disponible en: https://www.elnacional.cat/ca/salut/salut-anuncia-cap-tindran-fisioterapeuta-2023_903624_102.html
Vuit claus sobre els nous rols professionals a l’atenció primària [Internet]. 2022. Available from: https://www.elcritic.cat/mes/ateneu-critic/vuit-claus-sobre-els-nous-rols-professionals-a-atencio-primaria-152461
Aiguadé Aiguadé R. La hora de la Atención Primaria. Fisioterapia. 2022;44:199–200.
COMUNICADO: La SERMEF pide a SATSE una rectificación | Sermef [Internet]. 2022. Disponible en: https://www.sermef.es/comunicado-la-sermef-exige-a-satse-una-rectificacion/
Contra las declaraciones de los médicos rehabilitadores - cfisiomad [Internet]. 2022 . Disponible en: https://cfisiomad.org/noticias/contra-las-declaraciones-de-los-medicos-rehabilitadores/
El alarmismo generado por la SERMEF indica el desconocimiento de esta Sociedad sobre las competencias de los fisioterapeutas [Internet]. 2022. Disponible en: https://cpfcyl.com/contenidos/1/contenido/788
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