Implementation of Direct Access Physiotherapy Policy in Saudi Arabia: Insights from Practicing Physiotherapists: A...

Direct access to physical therapy (DAPT) services has attracted global attention for its potential to promote healthcare coverage, access, and equity. This study investigated physical therapists' opinions on DAPT practice, including awareness, perceived barriers, potential benefits, and implications for healthcare.

A cross-sectional study was used to survey 137 physical therapists from governmental, semi-governmental, and private centers. The Bury and Stokes tool was used to evaluate the DAPT opinions that were originally assessed in the views of World Confederation for Physical Therapy (WCPT) members on DAPT policy. The link to the questionnaire and informed consent was emailed to the physiotherapists. Data was reported in percentages and means as appropriate. Mann‒Whitney U-test and the Kruskal‒Wallis test were employed to explore associations between variables.

The physiotherapists demonstrated good theoretical knowledge (65.7%) and understanding of DAPT concepts (73%). The overall awareness score was 2.46 ± 0.48 out of 3. Many supported (80.3%) and were willing to practice DAPT (77.7%). Out of a total mean score of 5, major concerns include physicians' views score (3.32 ± 1.12), lack of evidence-based practices (3.07 ± 1.06), lack of professional competencies (3.01 ± 1.06), and payment models (3.2 ± 1.11). The documented advantages encompass enhanced patient satisfaction (4.19 ± 0.79), expedited services (4.32 ± 0.75), and elevated professional standing (4.33 ± 0.74). Senior practitioners demonstrated a higher level of awareness in comparison to their junior colleagues (score: 2.4 vs 2.6; p=0.004). Additionally, physiotherapists with over 25 years of clinical experience recognized the benefits of direct access over their counterparts with lesser experience (> 25 years' experience median score 4.5; vs median scores < 4 for all lesser experience groups; p<0.003).

This study emphasizes physiotherapists' opinions and positive attitudes regarding the DAPT policy implementation in Saudi Arabia. Nevertheless, addressing the challenges identified through education, advocacy, policy adjustments, and collaboration between stakeholders can enhance the accessibility, quality, and overall delivery of physiotherapy services.