Authors (including presenting author) :
Leung KKL(1), Chau RMW(1), Poon MWY(2), Chau DKW(3), Lau MHL(1), Lam CPY(1), Chan ACM(3)
Affiliation :
(1)Physiotherapy Department, Kowloon Hospital, (2)Physiotherapy Department, Hong Kong Buddhist Hospital, (3)Physiotherapy Department, Queen Elizabeth Hospital
Introduction :
The prevalence of musculoskeletal pain has been increasing globally in the past decades due to population growth, ageing and sedentary lifestyles. Though most musculoskeletal conditions are self-limiting, about one-fifth of patients develop chronic pain, which has negative impacts on patients’ quality of life and leads to substantial financial burdens to society. Early intervention is deemed crucial in preventing chronic pain development. Given the escalating physiotherapy service demands context, it is imperative to provide timely services to minimize the transition from acute to chronic pain. A triaged physiotherapy program has been implemented in the Kowloon Central Cluster Physiotherapy Outpatient Departments(KCCPTOPD) (pre-cluster boundary re-delineation) since 2015. All patients, regardless of the number of musculoskeletal conditions referred, were prioritized into three categories: Urgent(P1), Semi-urgent(P2) and Routine(R), according to the urgency of patients’ conditions.
Objectives :
To investigate the effectiveness of the triaged physiotherapy program in pain reduction and recovery in patients with multiple musculoskeletal conditions.
Methodology :
A retrospective longitudinal survey was conducted to collect demographic and clinical data from patients discharged from KCCPTOPD since 1.9.2016. Data of patients with multiple musculoskeletal conditions were extracted on 30.11.2019 for analysis.
Result & Outcome :
The current review included 3,159 patients with multiple musculoskeletal conditions, in which 8.8%, 24.5% and 64.2% of them were allocated to P1, P2 and R categories respectively, with mean waiting times of 8.36±9.24 days, 39.19±19.14 days and 111.32±43.66 days(p< 0.001). Age (mean:58.16±12.63 years; p=0.950), baseline pain intensity (mean:6.33±2.22 on the 11-point numeric pain rating scale; p=0.088) and the number of attendances (mean:16.47±8.61 sessions; p=0.700) were comparable among the triage groups. Low back pain, followed by knee, neck and shoulder pain were the most common referred conditions. The average number of musculoskeletal conditions referred is 2.44. All groups demonstrated statistically and clinically significant pain reduction after physiotherapy interventions(p< 0.001) with no between-group difference found(p=0.287). The mean self-perceived recovery was 77.56±12.46%, with no between-group difference found(p=0.837). The current triaged physiotherapy program was effective in stratifying patients with multiple musculoskeletal conditions,despite different waiting durations and within resources constraint, to achieve satisfactory treatment outcomes. Integrated care of multiple musculoskeletal conditions is highly recommended since it reduces the risk of chronic pain development, and harvests opportunity cost derived from administration of recurrent registration for physiotherapy and longer care episode for the avoidable chronic condition, for the provision of effective physiotherapeutics.
