Acceptability to Patients of PhysioDirect Telephone Advice and Treatment Services: A Qualitative Investigation

In response to long patient waiting lists and problems of access, several primary care trusts have developed telephone assessment and treatment services led by physiotherapists (Foster et al., 2011). The PhysioDirect trial funded by the Medical Research Council is a randomized trial comparing this approach with usual physiotherapy care (Salisbury et al., 2009). This nested qualitative study aimed to explore and understand the key issues that determine patient acceptability of the PhysioDirect service. Methods Semi‐structured interviews were conducted with 57 purposively sampled patients with musculoskeletal problems participating in the randomized trial. The framework method (Ritchie and Lewis, 2003) was used to analyse the qualitative data. Results Acceptable features of the new PhysioDirect service were that patients considered it to be prompt, accessible and efficient. However, these benefits were often ‘traded off’ with less acceptable features. For example, patients perceived the PhysioDirect telephone assessment to be less personal than face‐to‐face contact, and some found it difficult to explain functional problems over the telephone. Patients who chose not to re‐contact the PhysioDirect service despite ongoing symptoms explained that this was because of reluctance to explain their problem again, fears about miscommunication and an inability to recall the advice from the first telephone call. Despite these reservations, most patients could foresee PhysioDirect within future physiotherapy services. Conclusions Overall, patients found the PhysioDirect service acceptable and thought it to be prompt, accessible and efficient, yet these benefits were traded off with several less acceptable features. To conclude, the qualitative evidence suggests that there are no major patient barriers to their utilization of the PhysioDirect service. Copyright © 2012 John Wiley & Sons, Ltd.