Physiotherapists & prescription of NSAIDs
In 2008 IAP conf. Dr. B.S. Desikamani told the outlines of an extended scope practice. If you are an IAP member, then you might be remembering the demands of Bihar chapter of IAP on use of PAINKILLERS by a physiotherapists. There was a lot of hue and cry about the issue. The case was even in court whether physiotherapists should prescribe NDAIDS or not. There is no opinion or research available that leads us to conclude the demands of other physiotherapists of India. We present the following, a review of Australian physiotherapist’s use of NSAIDs. This article is composed from articles of Kumar S & Grimmer K.
In Australia, physiotherapy is a primary contact profession when practiced in private ambulatory settings. Primary contact means that physiotherapists take responsibility for diagnosis, decisions on interventions, appropriate ongoing management, and costs related to benefits. For most physiotherapists, the most common clinical presentations relate to symptoms from musculoskeletal conditions. There is considerable research evidence for many "physiotherapy" techniques in the management of musculoskeletal symptoms.
Physiotherapists do not have the training or the legislative powers to prescribe NSAIDs. As part of these management strategies, some physiotherapists may use nonsteroidal antiinflammatory drugs (NSAIDs) as an adjunct to treatment on non-prescription dispensing mode. A written survey instrument was developed and administered to 750 physiotherapists in South Australia, Tasmania and the Australian Capital Territory (50% of the registered physiotherapists). Responses were received from 285 physiotherapists. The survey identified opportunities for patient misuse and misadventures with NSAIDs in conjunction with physiotherapy management. Differences in physiotherapist understanding of the dosage and actions of oral and topic administrations of NSAIDs were highlighted, as were the moral and ethical responsibilities of physiotherapists to patients considering taking NSAIDs. The study identified the need for regular professional updates on quality use of NSAIDs.
However, physioterapists can recommend that patients seek advice about appropriate adjunct NSAIDs from pharmacists and/or medical practitioners. The roles and responsibilities of key health providers in this area appear to be well defined in terms of minimizing medication misadventure and optimizing patient health outcomes. This survey of physiotherapist behaviors and practices, however, identified a number of "gray" areas that could confront unwary physiotherapists, or pose dilemmas for those without the support of medical/pharmacist colleagues. These gray areas relate to the adjunct use of topical NSAIDs in physiotherapy management and making recommendations for the use of oral NSAIDs.
This paper reports on qualitative data that highlights the dilemmas confronting physiotherapists.
Now folks:
1. Does a physiotherapist in a graduation syllabus cover enough pharmacology to co-prescribe some medications like NSAIDS in musculoskeletal practice or inhaler administration during chest physiotherapy of asthma?
2. Do you know how Dentists ware resisted 30-40 years back when they started prescribing medications or even writing doctor in front of their mane? Now compare today’s scenario.
3. Have you ever compared how Podiatry an allied health science is growing in this aspect?
The need is immense of co-prescription of adjuvant medications in physiotherapy practice. To make an essential first hand practice it is at most necessary. For that I think a modification is required in syllabuses we cover. If that is not possible ESP modules must be available to fulfill the lacuna that a first hand physiotherapist feels while practicing the profession. In my opinion a physiotherapist bias exists around the world; we should resolve it come what may.
In Australia, physiotherapy is a primary contact profession when practiced in private ambulatory settings. Primary contact means that physiotherapists take responsibility for diagnosis, decisions on interventions, appropriate ongoing management, and costs related to benefits. For most physiotherapists, the most common clinical presentations relate to symptoms from musculoskeletal conditions. There is considerable research evidence for many "physiotherapy" techniques in the management of musculoskeletal symptoms.
Physiotherapists do not have the training or the legislative powers to prescribe NSAIDs. As part of these management strategies, some physiotherapists may use nonsteroidal antiinflammatory drugs (NSAIDs) as an adjunct to treatment on non-prescription dispensing mode. A written survey instrument was developed and administered to 750 physiotherapists in South Australia, Tasmania and the Australian Capital Territory (50% of the registered physiotherapists). Responses were received from 285 physiotherapists. The survey identified opportunities for patient misuse and misadventures with NSAIDs in conjunction with physiotherapy management. Differences in physiotherapist understanding of the dosage and actions of oral and topic administrations of NSAIDs were highlighted, as were the moral and ethical responsibilities of physiotherapists to patients considering taking NSAIDs. The study identified the need for regular professional updates on quality use of NSAIDs.
However, physioterapists can recommend that patients seek advice about appropriate adjunct NSAIDs from pharmacists and/or medical practitioners. The roles and responsibilities of key health providers in this area appear to be well defined in terms of minimizing medication misadventure and optimizing patient health outcomes. This survey of physiotherapist behaviors and practices, however, identified a number of "gray" areas that could confront unwary physiotherapists, or pose dilemmas for those without the support of medical/pharmacist colleagues. These gray areas relate to the adjunct use of topical NSAIDs in physiotherapy management and making recommendations for the use of oral NSAIDs.
This paper reports on qualitative data that highlights the dilemmas confronting physiotherapists.
Now folks:
1. Does a physiotherapist in a graduation syllabus cover enough pharmacology to co-prescribe some medications like NSAIDS in musculoskeletal practice or inhaler administration during chest physiotherapy of asthma?
2. Do you know how Dentists ware resisted 30-40 years back when they started prescribing medications or even writing doctor in front of their mane? Now compare today’s scenario.
3. Have you ever compared how Podiatry an allied health science is growing in this aspect?
The need is immense of co-prescription of adjuvant medications in physiotherapy practice. To make an essential first hand practice it is at most necessary. For that I think a modification is required in syllabuses we cover. If that is not possible ESP modules must be available to fulfill the lacuna that a first hand physiotherapist feels while practicing the profession. In my opinion a physiotherapist bias exists around the world; we should resolve it come what may.
Comments
Post a Comment