Evaluation of a primary care musculoskeletal clinical assessment service: a preliminary study
Ruth Sephton1, Elaine Hough, Stephen A Roberts
1Physiotherapy Department, St Helens Hospital, Marshalls Cross Road, St Helens WA9 3DA, UK. ruth.sephton@knowsley.nhs.uk
Objectives:
To evaluate the clinical effectiveness of a primary care musculoskeletal clinical assessment service (MCAS). The MCAS is a triage and treatment service for the management of patients with musculoskeletal conditions.
Design:
Prospective observational cohort study.
Participants:
Consecutive patients with musculoskeletal disorders referred to the MCAS from primary care over a 6-month period.
Interventions:
Patients were managed within the service in accordance with usual MCAS management/treatment pathways.
Main Outcome Measures:
Previously validated self-administered questionnaires were selected as outcome measures in order to facilitate the use of postal responses. These comprised two generic health status questionnaires (Short Form 36, EuroQol EQ-5D), a pain assessment using a visual analogue scale and two measures of patient satisfaction (Perceived Improvement Evaluation, Deyo and Diehl satisfaction questionnaire). Outcome measures were taken at baseline, and 3 and 12 months after recruitment.
Results:
In total, 217 patients were recruited into the study. Significant improvement was demonstrated with EuroQol at 3 and 12 months (P=0.043 and 0.035, respectively) and the pain visual analogue scale at 3 and 12 months (P=0.001 and 0.002, respectively). No significant differences were demonstrated with Short Form 36 (P=0.73 and 0.87). The mean patient-perceived improvement was 33% at 3 months and 46% at 12 months. Results showed high levels of patient satisfaction, with 72% of patients indicating total satisfaction with all aspects of the MCAS.
Conclusions:
Nationally, models similar to the MCAS have been developed to help improve care for patients and achieve the 18-week access target. This preliminary study shows the possible benefits of adopting this model of care, and identifies the need for further research.
