A qualitative investigation into how physiotherapists currently review people with Multiple Sclerosis and their opinions of telephone reviews in this population

Background: Guidelines recommend people with Multiple Sclerosis (PwMS) receive regular physiotherapy reviews (NICE, 2003). However little is known about how PwMS are currently reviewed. Reviews can be face-to-face, telephone or postal. The telephone is increasingly used to improve access to healthcare systems (Car, 2003). Yet no research is available on using telephone reviews with PwMS. Objectives: To explore: (i) how physiotherapists currently review PwMS and (ii) physiotherapists' opinions of telephone reviews in this population. Methods: Three focus groups were conducted with physiotherapists working with PwMS in urban (n=4) and rural (n=2) primary care settings and an acute hospital (n=3). Sessions were audio-recorded, transcribed verbatim and thematic analysis was performed. Results: Physiotherapists conversed that reviewing PwMS is not regularly done due to service constraints and inconsistencies in patient review pathways. Despite this, service provision was enhanced mainly by MS Ireland. Telephone reviews were perceived as beneficial. However concerns regarding compromised quality of care arose due to loss of visual cues, patients' ability to self-report and confidentiality issues. Concerns were allayed somewhat if a reliable self-reporting patient was chosen, reviews were structured and based on function. Conclusion: Physiotherapists are not regularly reviewing PwMS due to cutbacks in health services and problems with patient pathways. Due to the current economic climate further research is best aimed at refining patient pathways. Used appropriately, telephone reviews with PwMS have the potential to beneficial. Further research is required to ascertain benefits in reality and to ensure the safety of telephone reviews in this population.