“It's second best”: A mixed-methods evaluation of the experiences and attitudes of people with musculoskeletal pain towards physiotherapist delivered telehealth during the COVID-19 pandemic

• Published in: Musculoskeletal science & practice Vol. 58; no. NA; p. 102500
• Main Authors: Barton, C.J., Ezzat, A.M., Merolli, M., Williams, C.M., Haines, T., Mehta, N., Malliaras, P.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.04.2022; Published by Elsevier Ltd
• Subjects: Attitude; Australia; Coronavirus; COVID-19; Humans; Musculoskeletal; Musculoskeletal Pain - therapy; Pandemics; Physical Medicine and Rehabilitation; Physical Therapists; Physiotherapy; Telehealth; Telemedicine - methods; Australia; Coronavirus; Telehealth; Musculoskeletal; Physiotherapy
• ISSN: 2468-7812; 2468-8630; 2468-7812
• DOI: 10.1016/j.msksp.2021.102500

Musculoskeletal physiotherapy practice rapidly adopted telehealth during the COVID-19 pandemic, providing a unique opportunity to evaluate the experiences and attitudes of people who would not usually engage with these services. A sequential mixed-methods study recruited people with musculoskeletal pain conditions accessing Australian private practice physiotherapist services. Part 1 involved an online survey of telehealth services accessed, treatments and resources provided, self-reported global change in condition, and attitudes toward telehealth. Part 2 involved semi-structured interviews with a subset of survey participants, exploring experiences and attitudes towards telehealth. Quantitative data was reported descriptively. Qualitative data was evaluated using inductive thematic analysis. 172 participants responded to the survey, and 19 were interviewed. 95% accessed video-based telehealth, and 85% reported condition improvement. 84% agreed it was an efficient use of their time, 75% agreed it was financially viable, and 73% agreed their condition was accurately diagnosed. 62% percent believed telehealth should be less expensive than in-person services. Qualitative analysis revealed four themes (17 subthemes), including (i) telehealth had value, but generally perceived as inferior to in-person care; (ii) challenges related to assessment, diagnosis, ‘hands on’ treatment, observation, communication, and technology; (iii) advantages to access safe, expert, and convenient care; and (iv) importance of supportive technology, including video and supplementary resources. Physiotherapist telehealth services provided to people with musculoskeletal pain during the pandemic was valued. However, telehealth was generally perceived as inferior to traditional in-person care, and may be best used as part of a hybrid model of care. •85% of survey respondents accessing telehealth reported condition improvement.•Telehealth was valued, but typically considered inferior to in-person care.•62% of survey respondents believed telehealth should be less expensive.•Key challenges included lack of ‘hands on’ treatment and technology.•Key benefits included access to safe, convenient, and expert care.