What is the role of advanced practice physiotherapy for adults in urgent care and emergency department settings? A scoping review

Emergency Departments (EDs) are under increasing pressures as a result of population ageing and increasing healthcare needs. Advanced Practice Physiotherapy (APP) has emerged as a model of care to help mitigate ED crowding and improve timely access to care. The purpose of this scoping review is to synthesize the existing evidence base regarding the role of APP practitioners in urgent care and ED settings. A comprehensive search was completed in the following electronic databases: MEDLINE (Ovid), Pubmed, EMBASE, CINAHL Complete, Epistemonikos, Central Register of Controlled Trials in the Cochrane Library and Scopus; WHO International Clinical Trials Registry Platform (ICTRP): www.who.int/ictrp/en/ , DART-Europe E-theses portal, Open Grey, and Trip Medical database. The reference list of included sources of evidence in the review were searched for additional sources. No date or language restrictions were applied to the database search. The studies selected presented quantitative or qualitative data related to the care of adults by advanced physiotherapy practitioners in an emergency setting. Screening and data charting was conducted by two reviewers. Data were synthesised descriptively and narratively. Thirty-two studies were included. Three randomised controlled trials (RCTs), two quasi-experimental studies, 19 observational studies, four mixed methods studies and four qualitative studies were included. APP care in emergency settings was generally shown to be safe, effective, and associated with reduced healthcare resource use, compared with usual care among patients with musculoskeletal complaints. Findings also indicated high diagnostic agreement with emergency medicine physicians, fewer imaging and medication prescriptions, and positive patient and staff experiences of APP-delivered care in emergency settings. This review supports the potential benefits and positive impact of APP in emergency settings. However, further research examining the effectiveness of APP in emergency settings through RCTs and cost-effectiveness analysis is warranted to adequately inform policymakers and guide clinical practice. Not applicable.