Introduction: Telehealth services have helped enable continuity of care during the coronavirus pandemic. We aimed to investigate use and views towards telehealth among allied health clinicians treating people with musculoskeletal conditions during the pandemic.
Methods: Cross-sectional international survey of allied health clinicians who used telehealth to manage musculoskeletal conditions during the coronavirus pandemic. Questions covered demographics, clinician-related factors (e.g. profession, clinical experience and setting), telehealth use (e.g. proportion of caseload, treatments used), attitudes towards telehealth (Likert scale), and perceived barriers and enablers (open questions). Data were presented descriptively, and an inductive qualitative thematic content analysis approach was used for qualitative data, based on the Capability-Opportunity-Motivation Behavioural Model.
Results: 827 clinicians participated, mostly physiotherapists (82%) working in Australia (70%). Most (71%, 587/827) reported reduced revenue (mean (SD) 62% (24.7%)) since the pandemic commenced. Median proportion of people seen via telehealth increased from 0% pre (IQR 0 to 1) to 60% during the pandemic (IQR 10 to 100). Most clinicians reported managing common musculoskeletal conditions via telehealth. Less than half (42%) of clinicians surveyed believed telehealth was as effective as face-to-face care. A quarter or less believed patients value telehealth to the same extent (25%), or that they have sufficient telehealth training (21%). Lack of physical contact when working through telehealth was perceived to hamper accurate and effective diagnosis and management.
Discussion: Despite high rates of adoption and reported confidence among clinicians, most clinicians they lacked adequate training to deliver telehealth services, and that telehealth was less effective than face-to-face care and undervalued by patients. These views are contrary to emerging evidence evaluating efficacy in musculoskeletal pain conditions, including high patient satisfaction and equivalent clinical outcomes. Our data suggests that many clinicians adopted telehealth due to necessity, making it questionable whether they would persist with its use once barriers to face-to-face care were removed. Future research should consider strategies to address clinician barriers (e.g. training opportunities) to telehealth as well as improving the current evidence base.
Conflict of interest statement: The authors have no conflict of interest of relevance to the submission of this abstract.