TABLE 4 -.

Summary of primary studies (n = 4)

Individual studies
Study and country	Design, aim of the study	Study setting, population, sample size	Intervention	Outcome measures
Crowell et al (2022) (23) United States	Retrospective data analysis cohort study	To compare rates of compliance with the National Committee for Quality Assurance – Healthcare Effectiveness Data and Information Set (HEDIS) recommendations for diagnostic imaging in low back pain between physical therapists and primary care providers in young, athletic patients	Analysis of 1,845 Military Health System Data Repository (MDR) data	In the physical therapy clinic, 96.7% of encounters did not have imaging ordered within the first 28 days of onset of symptoms, compared with 82.0% in the primary care clinic (p < 0.001).
Halfpap et al (2022) (25) United States	Retrospective trial on low back pain in military	To compare DA PT in (acute) low back pain to random retrospective sample	1,215 patients compared to 100 randomly selected patients’ medical records	Medication: 26% in PT vs 20% in non-PT and 47.4%-72% in the ED Radiographs: 7% in PT vs. 28% in non-PT vs. 26.1 in the ED Complex Imaging: 1% in PT vs. 12% in non-PT vs. 8.2% in the ED
Reddington et al (2022) (22) UK	Descriptive nested qualitative study via semi-structured patient interview	To explore sciatica patients’ experiences with DA	80 patients with sciatica	This study suggests that accelerated access to physiotherapy has value in terms of aiding perceived recovery and/or halting further physical and psychological decline
Wood et al (2022) (24) UK	Online survey	Patient-reported experience and outcomes for DA	680 reported questionnaires and 785 free-text responses	Approximately 70% of participants reported no need for consulting other health care professionals

DA = direct access; ED = emergency department; PT = physiotherapy.