Effects of waiting for outpatient physiotherapy services in persons with musculoskeletal disorders: a systematic review

Abstract

Purpose: This systematic review aimed to assess the scientific evidence on the effects of waiting for outpatient physiotherapy services in persons with musculoskeletal disorders.

Methods: A literature search was conducted in three databases (Medline, CINAHL, and Embase) for articles assessing the effects of waiting for outpatient physiotherapy services in persons with musculoskeletal disorders. Clinical and health system outcomes were analyzed.

Results: Sixteen studies met the inclusion criteria for this review. The studies varied in designs, settings, and populations. The definition of waiting also varied between studies. The studies were of low to high methodological quality. Waiting for outpatient physiotherapy services was shown to have mixed results on clinical and health system outcomes. Results from included studies suggest the possible detrimental effects of waiting on pain, disability, quality of life, and psychological symptoms in persons with musculoskeletal disorders. There was also evidence of higher healthcare utilization and costs for patients who wait longer before physiotherapy services.

Conclusions: This review provides mixed evidence that suggest potential detrimental effects on the health of individuals with MSDs and at the health system level. Further high-quality studies are needed, such as longitudinal studies specifically addressing the effects of waiting due to lack of access to physiotherapy services.IMPLICATIONS FOR REHABILITATIONThe findings from this review suggest potential detrimental effects on health outcomes when patients wait longer before receiving physiotherapy services.The findings also suggest higher healthcare utilization and costs for patients with longer wait times compared to those who receive physiotherapy services more rapidly.This review suggests the need to assess and implement strategies and policies to ensure timely access to physiotherapy.

Keywords: Outpatient physiotherapy; access; clinical outcomes; economic outcomes; health system outcomes; musculoskeletal disorders; waiting time.