Characterization of the prescription of physical and rehabilitation medicine in health centers in the North of Portugal

Authors

  • Sandra Ribeiro USF Aníbal Cunha, ACeS Porto Ocidental. Porto, Portugal.
  • Ana Teresa Fróis Unidade de Saúde Familiar Horizonte, Unidade Local de Saúde de Matosinhos http://orcid.org/0000-0001-9940-5160
  • Joana Mendes USF S. Félix-Perosinho, ACeS Espinho/Gaia. S. Félix da Marinha, Portugal.
  • Joaquim Santos USF Bom Porto, ACeS Porto Ocidental. Porto, Portugal.

DOI:

https://doi.org/10.32385/rpmgf.v39i4.13535

Keywords:

Physical and rehabilitation medicine, Primary health care, Data analysis

Abstract

Introduction: Family doctors play a key role in identifying patients in need of and prescribing rehabilitation and physical medicine treatments. Since there is no central record of rehabilitation prescriptions, it is impossible to know the population of patients undergoing rehabilitation.

Objectives: Characterizing prescriptions of physical rehabilitation care from four primary care units in the North of Portugal, in 2019.

Methods: Observational, analytical, retrospective study of a randomized sample of 400 prescriptions of a first cycle in rehabilitation care, in four primary care units, in 2019.

Results: In the analyzed sample, the majority of the patients were female, with an average age of 58 years, an education level equal to or inferior to primary education, and not working at the moment of the prescription. Most prescriptions were due to musculoskeletal complaints (71%), followed by unspecific causes (17%), and the nervous system (5%). From the musculoskeletal motives, 43% were degenerative, 21% inflammatory, and 8% traumatic. From the analyzed initial prescriptions, 61% were not followed by subsequent prescriptions.

Conclusions: This study characterizes the patients and the motives that lead physicians of four primary care units to prescribe rehabilitation care. Musculoskeletal diseases were the leading cause of rehabilitation care prescription. The majority of the population had low education and was retired/unemployed despite still being of working age. Most of the initial treatments were not followed by subsequent prescriptions. This study can be a starting point for future investigations and practice improvements in this care area.

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References

Faria F. A medicina física e reabilitação no século XXI: desafio e oportunidades [Physical and rehabilitation medicine in the XXI century: challenges and opportunities]. Acta Fisiatr. 2010;17(1):44-8. Portuguese

Amaro J, Moreira J, Branco CA. Medicina física e de reabilitação: a especialidade médica [Physical and rehabilitation medicine: the medical specialty]. Rev SPMFR. 2009;18(2):22-8. Portuguese

Sociedade Portuguesa de Medicina Física e de Reabilitação. Especialidade médica [homepage]. SPMFR; 2023 Mar. Available from: http://www.spmfr.org/a-fisiatria/especialidade-medica/

Sampaio F, Pinto CV, Parada F, Antunes F, Silva HT, Caldas J, et al. Medicina Física e de Reabilitação: rede nacional de especialidade hospitalar e de referenciação [Internet]. Lisboa: Ministério da Saúde; 2017. Available from: https://www.acss.min-saude.pt/wp-content/uploads/2017/03/RNEHRMedFisicaReab_vf.pdf

Administração Central do Sistema de Saúde. Tabela de MCDT convencionados – medicina física e de reabilitação: circular normativa n.º 32/2011/UOFC, de 24/11/2011. Lisboa: ACSS; 2011.

Entidade Reguladora da Saúde. Informação de monitorização: setor convencionado de medicina física e reabilitação [Internet]. Porto: ERS; 2022 Dec 06. Available from: https://www.ers.pt/media/fnyekzm2/im-setor-convencionado-de-medicina-f%C3%ADsica-e-reabilita%C3%A7%C3%A3o_2022.pdf

Vital E. Fisioterapia e medicina geral e familiar: que diálogo? Fisio Bol Inf. 2013;(14):16-8.

Entidade Reguladora da Saúde. Caracterização do acesso dos utentes a serviços de medicina física e de reabilitação [Internet]. Porto: ERS; 2008 Apr. Available from: https://www.ers.pt/uploads/writer_file/document/96/MFR-Relatoriofinal.pdf

Ferreira SJ. Fisioterapia: avaliação dos ganhos de utilidade [dissertation]. Bragança: Instituto Politécnico de Bragança; 2012. Available from: http://hdl.handle.net/10198/8228

Swinkels IC, Hart DL, Deutscher D, van den Bosch WJ, Dekker J, de Bakker DH, et al. Comparing patient characteristics and treatment processes in patients receiving physical therapy in the United States, Israel and the Netherlands: cross sectional analyses of data from three clinical databases. BMC Health Serv Res. 2008;8:163.

Evensen KA, Robinson HS, Meisingset I, Woodhouse A, Thielemann M, Bjorbækmo WS, et al. Characteristics, course and outcome of patients receiving physiotherapy in primary health care in Norway: design of a longitudinal observational project. BMC Health Serv Res. 2018;18(1):936.

Jesus TS, Landry MD, Hoenig H. Global need for physical rehabilitation: systematic analysis from the Global Burden of Disease Study 2017. Int J Environ Res Public Health. 2019;16(6):980.

Hartvigsen J, Hancock MJ, Kongsted A, Louw Q, Ferreira ML, Genevay S, et al. What low back pain is and why we need to pay attention. Lancet. 2018;391(10137):2356-67.

Hallegraeff JM, van der Schans CP, Krijnen WP, HG de Greef MH. Measurement of acute nonspecific low back pain perception in primary care physical therapy: reliability and validity of the brief illness perception questionnaire. BMC Musculoskelet Disord. 2013;14:53.

Cieza A, Causey K, Kamenov K, Hanson SW, Chatterji S, Vos T. Global estimates of the need for rehabilitation based on the Global Burden of Disease study 2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2021;396(10267):2006-17.

Vital E. Fisioterapia nos Agrupamentos de Centros de Saúde da Administração Regional de Saúde do Centro: traços de uma realidade. Fisio Bol Inf. 2013;(13):10-6.

Pisters MF, Veenhof C, van Meeteren NL, Ostelo RW, de Bakker DH, Schellevis FG, et al. Long-term effectiveness of exercise therapy in patients with osteoarthritis of the hip or knee: a systematic review. Arthritis Rheum. 2007;57(7):1245-53.

Aoyagi K, Neogi T, Peloquin C, Dubreuil M, Marinko L, Camarinos J, et al. Association of physical therapy interventions with long-term opioid use after total knee replacement. JAMA Netw Open. 2021;4(10):e2131271.

Bannuru RR, Osani MC, Vaysbrot EE, Arden NK, Bennell K, Bierma-Zeinstra SM, et al. OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis. Osteoarthritis Cartilage. 2019;27(11):1578-89.

Kreiner DS, Matz P, Bono CM, Cho CH, Easa JE, Ghiselli G, et al. Guideline summary review: an evidence-based clinical guideline for the diagnosis and treatment of low back pain. Spine J. 2020;20(7):998-1024.

Boissonnault WG, Ross MD. Physical therapists referring patients to physicians: a review of case reports and series. J Orthop Sports Phys Ther. 2012;42(5):446-54.

Despacho nº 10.430/2011, de 8 de agosto. Diário da República. II Série;(158).

Portaria n.º 178-A/2016, de 1 de julho. Diário da República. I Série;(125 Suppl 1).

Hendriks EJ, Kerssens JJ, Nelson RM, Oostendorp RA, van der Zee J. One-time physical therapist consultation in primary health care. Phys Ther. 2003;83(10):918-31.

Published

2023-09-14

How to Cite

Ribeiro, S., Fróis, A. T., Mendes, J., & Santos, J. (2023). Characterization of the prescription of physical and rehabilitation medicine in health centers in the North of Portugal. Portuguese Journal of Family Medicine and General Practice, 39(4), 273–82. https://doi.org/10.32385/rpmgf.v39i4.13535