Patient satisfaction with advanced practice physiotherapy internationally: A systematic mixed studies review.

Area of Science:

• Physiotherapy
• Healthcare Quality
• Patient Experience

Background:

• Advanced practice physiotherapy (APP) represents a higher level of practice with expert clinical and analytical skills.
• Patient satisfaction is a key indicator of healthcare quality and patient experience.
• Existing evidence on patient satisfaction with APP is not comprehensively synthesized across different settings.

Purpose of the Study:

• To conduct a comprehensive international evaluation of patient satisfaction with advanced practice physiotherapy (APP).
• To identify and assess the human and system attributes that influence patient satisfaction with APP.

Main Methods:

• A systematic mixed-methods review using a parallel-results convergent synthesis design.
• Searched key databases and grey literature for studies measuring patient satisfaction with APP from inception to September 2025.
• Integrated narrative (quantitative) and thematic (qualitative) syntheses, with evidence confidence assessed by GRADE/GRADE-CERQual.

Main Results:

• Included 35 studies of varying quality (high, moderate, low).
• Thematic synthesis indicated moderate-to-high confidence in human attributes (e.g., communication, expertise, empowerment) and moderate confidence in system attributes (e.g., access, convenience, integrated care) driving satisfaction.
• Narrative synthesis found very low certainty evidence for overall and human attributes, and mostly high certainty for system attributes.

Conclusions:

• Both human and system attributes significantly contribute to high patient satisfaction with APP.
• AP physiotherapists are integral to patient satisfaction, aligning with findings in other healthcare professions.
• Future high-quality research is essential due to the very low certainty of quantitative evidence to guide APP service development.