JMIR Publications

ABSTRACT

Background:

As the prevalence of musculoskeletal disorders (MSDs) increases, an increasing work burden is expected for physiotherapists in the primary healthcare sector. Digital health technologies are proposed as a viable solution to secure the sustainability of the healthcare system, and has shown promising results in a range of conditions. However, the adoption rate of technology is slow, and little is known about the use of digital health technologies among physiotherapists in the primary healthcare sector in Norway.

Objective:

To investigate use of and attitudes towards digital health technologies among physiotherapists treating patients with MSDs in primary care in Norway, and potential factors acting as facilitators or barriers for adopting digital health technologies in clinical practice.

Methods:

A web-based questionnaire was distributed to municipal-employed physiotherapists and physiotherapists working in private practice in all Norwegian municipalities in March 2023. The questionnaire included items regarding use of technologies, attitudes, suitability and factors influencing adoption of digital health technology. Suitability and agreement on statements were scored on a 10-point numeric rating scale (0=very unsuitable/strongly disagree, 10=very suitable/strongly agree).

Results:

Approximately 5000 physiotherapists were invited to participate, of which 6.8% (338) completed the questionnaire, equally divided between municipality-employed physiotherapists and physiotherapists in private practice. A total of 46.2% (156/338) offered digital health technologies in their practice. Of those offering, 53.2% (83/156) utilized digital health technologies on a weekly basis, mostly telephone consultations (105/156, 67.3%). A large majority of the physiotherapists (272/335, 81.2%) were positive to recommending digital health technologies to their patients. Suitability of digital health technologies in physiotherapy was rated 6.0 (SD 2.1), with apps for smartphones/tablets rated most suitable (6.8, SD 2.4). The most frequently reported advantages were flexibility in how physiotherapy is offered (278/338, 82.3%) and reduced travel time for the patient (235/338, 70%). The highest rated disadvantages were limited scope for the physical examination (252/338, 74.6%) and difficulty in building a rapport with the patient (227/338, 67.2%). The main facilitator and barrier were a functioning (8.5, SD 2.3) or lack of functioning (8.2, SD 2.6) internet connection. Lack of training in digital health technologies was prominent, both regarding evaluation and diagnosing (1.2, SD 2.0) and treatment (1.4, SD 2.1).

Conclusions:

Physiotherapists in Norwegian primary care treating patients with MSDs are positive to using digital health technologies, and almost 50% have adapted it in clinical practice, particularly those in private practice. Advantages reflect benefits for both the physiotherapist and the patient. Concerns are related to the lack of a physical examination, with facilitators and barriers related to technical aspects. Lack of training is prominent, and should be addressed in future research and implementation.