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Perceptions of Australian physiotherapy students about the potential implementation of physiotherapist prescribing in Australia: a national survey.

ABSTRACT: OBJECTIVES:To explore the perceptions of Australian physiotherapy students about (1) the potential implementation and use of non-medical prescribing by physiotherapists in Australia and (2) how physiotherapist prescribing might impact the care that the physiotherapy profession can provide in the future. DESIGN:A cross-sectional descriptive survey of physiotherapy students across Australia was completed using an online questionnaire developed by subject-experts and pretested (n=10) for internal consistency. A hyperlink to the questionnaire was emailed to all students enrolled in any accredited, entry-level Australian university physiotherapy programme. A reminder email was sent 4 weeks later. SETTING:Participants completed an online questionnaire. PARTICIPANTS:526 physiotherapy students from universities across all states with entry-level programmes. OUTCOME MEASURES:Quantitative data underwent primary descriptive analysis. Thematic analysis was used to synthesise qualitative data. RESULTS:87% of participants supported the introduction of physiotherapist prescribing in Australia. 91% of participants stated that they would train to prescribe following introduction. Participants identified improvements in clinical and cost effectiveness, timely access to appropriate prescription medicines and optimisation of quality healthcare as key drivers for the introduction. CONCLUSIONS:Student physiotherapists support the introduction of physiotherapist prescribing in Australia, reporting potential benefits for patients, health services and the physiotherapy profession. Stakeholders should use the results of this study in conjunction with supporting literature to inform future decisions regarding physiotherapist prescribing in Australia.

SUBMITTER: Noblet TD

PROVIDER: S-EPMC6530448 | biostudies-literature | 2019 May

REPOSITORIES: biostudies-literature

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Perceptions of Australian physiotherapy students about the potential implementation of physiotherapist prescribing in Australia: a national survey.

Noblet Timothy David TD Marriott John F JF Jones Taryn T Dean Catherine C Rushton Alison B AB

BMJ open 20190519 5

<h4>Objectives</h4>To explore the perceptions of Australian physiotherapy students about (1) the potential implementation and use of non-medical prescribing by physiotherapists in Australia and (2) how physiotherapist prescribing might impact the care that the physiotherapy profession can provide in the future.<h4>Design</h4>A cross-sectional descriptive survey of physiotherapy students across Australia was completed using an online questionnaire developed by subject-experts and pretested (n=10) ...[more]

PMID: 31110095

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Project description:OBJECTIVES:To explore: (1) the views of Australian physiotherapists regarding potential implementation of non-medical prescribing in Australia, (2) how the geographical location and health sector in which a clinician works may influence their perceptions and (3) the perceptions of Australian physiotherapists about how physiotherapist prescribing might impact the care that the profession can provide. DESIGN:A cross-sectional descriptive survey using open and closed questions. SETTING:Participants completed an online questionnaire. PARTICIPANTS:883 Australian Health Professionals Registration Authority (AHPRA)-registered physiotherapists, working across all states and territories. OUTCOME MEASURES:An online questionnaire was developed by a panel of subject experts and pretested (n=10) for internal consistency. A hyperlink to the questionnaire was emailed to all members of the Australian Physiotherapy Association. A reminder email was sent 4 weeks later. Quantitative data were analysed descriptively, with use of absolute risk reductions (ARRs) and 95% CIs to determine the likelihood that health sector or geographical location were associated with specific views. Thematic analysis enabled synthesis of the qualitative data. RESULTS:79.0% participants felt that physiotherapist prescribing should be introduced in Australia, with 71.2% wanting to train as prescribers. Clinical governance, risk management, regulation of clinicians and the development of an education framework were identified as priorities for implementation. Participants working in the private sector were significantly more likely to train as prescribers than those in the public sector (ARR 9.9%; 95% CI 3.5 to 16.4) or educational/research institutions (ARR 23.3%; 95% CI 12.8 to 33.8), with city dwellers significantly more likely to train compared with physiotherapists in remote regions (ARR 19.8%; 95% CI 0.8 to 39.2). Physiotherapist prescribing was predicted to improve efficiency of healthcare delivery, access to medicines and reductions in healthcare costs. CONCLUSIONS:AHPRA-registered physiotherapists perceive that the introduction of autonomous physiotherapist prescribing would be beneficial for the Australian population and should be introduced. Decision makers should consider the results of this survey in conjunction with cost-benefit and risk analysis when planning the introduction of physiotherapist prescribing.

Project description:ImportanceBenzodiazepines have been a common target for policy interventions to curtail inappropriate use, with mixed results. To reduce alprazolam misuse, in February 2017, Australia delisted the 2-mg tablet strength from public subsidy, eliminated refills, and reduced the pack size from 50 tablets to 10 tablets.ObjectiveTo describe changes in alprazolam dispensing, prescribing, and poisonings associated with the implementation of a new policy to reduce inappropriate prescription of alprazolam in Australia.Design, setting, and participantsThis interrupted time series analysis and cross-sectional study included data from a 10% sample of Australian people who received publicly subsidized dispensing claims and prescribing approvals for alprazolam from January 1, 2015, to December 31, 2018, and all calls to a poison information service involving alprazolam from February 1, 2015, to October 31, 2018. Autoregressive error models were used to quantify changes over time and compare patterns of use before and after the intervention. Data analyses were conducted from November 2018 to May 2019.ExposureImplementation of the policy change on February 1, 2017.Main outcomes and measuresMonthly trends in alprazolam prescribing approvals and dispensings, quarterly trends in telephone calls involving alprazolam to a poison information service, and patterns of prescribing and dispensing before and after the intervention.ResultsFrom 2015 to 2018, there were 71?481 alprazolam dispensings to 6772 people. After the intervention, overall dispensing decreased by 51.2% (95% CI, 50.5%-51.9%) and prescribing approvals increased by 17.5% (95% CI, 13.0%-22.2%). Overall, the proportion of dispensing of packs of 51 to 100 tablets increased from 5776 of 24?282 dispensings (23.8%) to 4888 of 10?676 dispensings (45.8%) (risk difference [RD], 22.0% [95% CI, 19.4%-24.6%]) and dispensing of packs of more than 100 tablets increased from 1029 of 24?282 dispensings (4.2%) to 1774 of 10?676 dispensings (16.6%) (RD, 12.4% [95% CI, 10.6%-14.2%]). Among people receiving their first alprazolam prescription, initiation with packs of 10 tablets or fewer increased from 16 of 1127 people (1.4%) before the intervention to 139 of 589 people (23.6%) after the intervention (RD, 22.2% [95% CI, 18.7%-25.7%]). Alprazolam treatment initiation with packs of more than 50 tablets also increased from 63 of 1127 people (5.6%) before the intervention to 144 of 589 people (24.4%) after the intervention (RD, 18.9% [95% CI, 15.1%-22.6%]). During 1 year before the intervention, patients received a median (interquartile range [IQR]) total of 250 (50-600) tablets and median (IQR) total combined tablet strength of 188 (50-550) mg. During 1 year after the intervention, people were dispensed less alprazolam, with a median (IQR) total of 200 (50-500) tablets and median (IQR) total combined tablet strength of 120 (30-360) mg. There was little change in poisoning calls involving alprazolam.Conclusions and relevanceThis study found that after the policy intervention, subsidized alprazolam use decreased, but the increase in prescribing approvals placed additional burden on prescribers. Even after the intervention, most people who were dispensed alprazolam were still receiving treatment contrary to best-practice recommendations. Furthermore, the poison information center data suggested that people were still being dispensed the 2-mg tablet strength, presumably as nonsubsidized (ie, private) prescriptions.

Project description:BackgroundNo documented standard or core competencies exist for paediatric curriculum in entry-level physiotherapy programs in Australia. Consequently, extensive variability is thought to exist amongst Australian entry-level physiotherapy programs for preparing physiotherapists to work safely and effectively with children. The purpose of this study was to explore the landscape of paediatric curriculum in Australian entry-level physiotherapy programs and identify the paediatric content being covered, its perceived importance according to university academics who teach paediatrics, the mode of delivery and assessment, and the strengths, weaknesses, barriers and facilitators to implementing paediatric curriculum.MethodsA web-based desktop audit and an online cross-sectional survey using closed and open-ended questions was administered to all Australian universities offering entry-level physiotherapy programs in November 2017. Content coverage and perceived level of importance for paediatric content areas were determined using Likert scale responses. Open-ended responses were thematically analysed to identify key themes for strengths, weaknesses and facilitators to implementation of paediatric curriculum.ResultsAll (n = 20, 100%) entry-level programs used the terms lifespan, child and/or paediatrics somewhere in at least one subject descriptor. Forty-five percent (n = 9) of universities did not use the terms lifespan, child or paediatric in their published learning objectives. Eight (40%) universities offered a paediatric stand-alone course. Sixty-five (13/20) percent of universities invited, responded to the survey. For paediatric conditions the perceived level of importance was predominately higher than its course content coverage for 19 of the 31 conditions surveyed. Key barriers to implementating paediatric curriculum were: crowded curriculum, limited financial resources resulting in a lack of qualified staff, lack of prioritisation of paediatric curriculum and inadequate paediatric placement availability. Facilitators for effective implementation of paediatric content were stand-alone paediatric subjects, demonstrated dedication to paediatric curriculum and having suitably qualified faculty members.ConclusionThe results of this survey provide the physiotherapy community with the views of paediatric physiotherapy academic educators regarding the content, perceived need to expand content delivery in identified clinical areas, and the barriers and facilitators to implementing paediatric content in Australian entry-level physiotherapy programs. Further research exploring similar questions with paediatric physiotherapy clinicians would complement the findings of this study.

Project description:Introduction: Since 1992 the Australian Government has funded a periodic national survey of HIV and Sexually Transmissible Infection (STI) knowledge and sexual risk behavior among secondary school students. Adolescents continue to be a priority population in public health efforts to reduce rates of STIs in Australia. The purpose of the survey is to inform progress on national strategic sexual health priorities. The results are used by federal and state/territory government agencies, youth-serving community organizations and health educators to improve knowledge, promote healthy sexual behaviors and target educational efforts aimed at communicating public health messages to young people. Materials and Equipment: The 6th survey entitled the "National Survey of Secondary Students and Adolescent Sexual Health" was conducted online in 2018 among 14-18 year olds living in Australia. The anonymous self-complete survey contained up to 286 items assessing three primary domains of knowledge, behaviors and education experiences. Factual knowledge measures covered HIV transmission and STI knowledge around transmission and prevention covering gonorrhea, Chlamydia, syphilis, hepatitis, herpes, and HPV. Behavioral measures examined perceived susceptibility, peer norms, protective behaviors, age of onset for various behaviors, reasons for not being sexually active yet, and/or sexual histories with additional detail on most recent sexual event. The 6th survey was completed by 8,400 Australian adolescents a represents a broad cross-section by age, gender, year in school, type of school (e.g., government, Catholic), and state/territory which closely matched census data on these strata. The one-of-a-kind survey instrument, grounded in public health theories, may prove valuable for public health researchers. Expected Impact of the Study on Public Health: Findings from the 6th National Survey of Secondary Students and Adolescent Sexual Health will contribute important insights into current knowledge, behaviors and educational experiences of young people. Results, similar to previous iterations of the survey, will inform public health practitioners, policymakers, educators, and advocates for the sexual health and well-being of young Australians. Results may assist sexual health services to align with broader public health goals articulated in the national HIV and STI strategies aimed to reduce the burden of disease and improve the quality of sexual lives of young Australians.

Dataset Information

Perceptions of Australian physiotherapy students about the potential implementation of physiotherapist prescribing in Australia: a national survey.

Publications

Perceptions of Australian physiotherapy students about the potential implementation of physiotherapist prescribing in Australia: a national survey.

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