{
  "abstract": "Objectives The objectives of this process evaluation were to explain the results of the REFORM (REhabilitation FOR Musculoskeletal conditions) trial and identify potential facilitators and barriers to the future rollout of a remotely delivered physiotherapy model of care.Setting Outpatient physiotherapy units in five government-funded public hospitals in Sydney, Australia.Design This process evaluation was run alongside the REFORM trial. The REFORM trial (n=210) set out to determine whether remotely delivered physiotherapy (with one initial face-to-face session with a physiotherapist) was as good or better than a course of face-to-face physiotherapy. The process evaluation was informed by The UK Medical Research Council Process Evaluation Guidance. It was also based on the Realist Evaluation and the dimensions of the Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) Framework. Qualitative and quantitative data were collected. The qualitative data included semistructured interviews. The quantitative data included audits of screening logs and participants’ self-reported satisfaction with service delivery. A thematic analysis using both inductive and deductive approaches was used for qualitative analysis. Multiple data were used to triangulate the process evaluation findings.Participants Quantitative data were collected on 210 participants. Qualitative interviews were conducted with 20 participants, 15 physiotherapists and 5 stakeholders.Results Some participants valued the convenience and accessibility of remotely delivered physiotherapy. It was also deemed to have the potential of improving the efficiency in the way physiotherapy is delivered. The findings from the RE-AIM framework were mixed. For example, the Reach was limited, and the Adoption and Maintenance were inconsistent across sites.Conclusion Remotely delivered physiotherapy has the potential to be rolled out across Australian clinical settings to participants similar to the REFORM trial. However, further research involving participants with different types and severity of musculoskeletal conditions is needed to improve the generalisability of our findings. Adoption might be improved with a hybrid model of care where physiotherapists’ and patients’ preferences are met.Trial registration number ACTRN12619000065190.",
  "authors": [
    {
      "affiliations": [
        "Kolling Institute, The University of Sydney Faculty of Medicine and Health, St Leonards, New South Wales, Australia",
        "Northern Sydney Local Health District, John Walsh Centre for Rehabilitation Research, St Leonards, New South Wales, Australia"
      ],
      "name": "Jackie Chu"
    },
    {
      "affiliations": [
        "Kolling Institute, The University of Sydney Faculty of Medicine and Health, St Leonards, New South Wales, Australia",
        "Northern Sydney Local Health District, John Walsh Centre for Rehabilitation Research, St Leonards, New South Wales, Australia"
      ],
      "name": "Hannah G Withers"
    },
    {
      "affiliations": [
        "Kolling Institute, The University of Sydney Faculty of Medicine and Health, St Leonards, New South Wales, Australia",
        "Northern Sydney Local Health District, John Walsh Centre for Rehabilitation Research, St Leonards, New South Wales, Australia"
      ],
      "name": "Joanne V Glinsky"
    },
    {
      "affiliations": [
        "University of New South Wales, The George Institute for Global Health, Sydney, New South Wales, Australia",
        "The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia"
      ],
      "name": "Hueiming Liu"
    },
    {
      "affiliations": [
        "Allied Health Services, Liverpool Hospital, Sydney, NSW, Australia"
      ],
      "name": "Matthew D Jennings"
    },
    {
      "affiliations": [
        "Physiotherapy Department, Blacktown and Mount Druitt Hospital, Blacktown, New South Wales, Australia"
      ],
      "name": "Ian J Starkey"
    },
    {
      "affiliations": [
        "Physiotherapy Department, Blacktown and Mount Druitt Hospital, Blacktown, New South Wales, Australia"
      ],
      "name": "Blake Palmer"
    },
    {
      "affiliations": [
        "Physiotherapy Department, Blacktown and Mount Druitt Hospital, Blacktown, New South Wales, Australia"
      ],
      "name": "Rachel Parmeter"
    },
    {
      "affiliations": [
        "Physiotherapy Department, Camden and Campbelltown Hospital, Sydney, NSW, Australia"
      ],
      "name": "Jackson J Cruwys"
    },
    {
      "affiliations": [
        "Physiotherapy Department, Camden and Campbelltown Hospital, Sydney, NSW, Australia"
      ],
      "name": "Max Boulos"
    },
    {
      "affiliations": [
        "Physiotherapy, Hornsby and Ku-ring-gai Hospital, Hornsby, New South Wales, Australia"
      ],
      "name": "Ian Jordan"
    },
    {
      "affiliations": [
        "Physiotherapy, Bankstown-Lidcombe Hospital, Bankstown, New South Wales, Australia"
      ],
      "name": "Maggie Duong"
    },
    {
      "affiliations": [
        "Physiotherapy Department, Camden and Campbelltown Hospital, Sydney, NSW, Australia"
      ],
      "name": "Kitty Duong"
    },
    {
      "affiliations": [
        "Physiotherapy Department, Liverpool Hospital, Sydney, NSW, Australia"
      ],
      "name": "David Wong"
    },
    {
      "affiliations": [
        "Physiotherapy, Royal North Shore Hospital, St Leonards, New South Wales, Australia"
      ],
      "name": "Tara E Lambert"
    },
    {
      "affiliations": [
        "Physiotherapy, Royal North Shore Hospital, St Leonards, New South Wales, Australia"
      ],
      "name": "Barbara R Lucas"
    },
    {
      "affiliations": [
        "Physiotherapy, Royal North Shore Hospital, St Leonards, New South Wales, Australia"
      ],
      "name": "Deborah Taylor"
    },
    {
      "affiliations": [
        "Institute of Musculoskeletal Health, The University of Sydney, Sydney, New South Wales, Australia"
      ],
      "name": "Christopher G Maher"
    },
    {
      "affiliations": [
        "Institute of Musculoskeletal Health, The University of Sydney, Sydney, New South Wales, Australia"
      ],
      "name": "Catherine Sherrington"
    },
    {
      "affiliations": [
        "Institute of Musculoskeletal Health, The University of Sydney, Sydney, New South Wales, Australia"
      ],
      "name": "Joshua R Zadro"
    },
    {
      "affiliations": [
        "Kolling Institute, The University of Sydney Faculty of Medicine and Health, St Leonards, New South Wales, Australia",
        "Northern Sydney Local Health District, John Walsh Centre for Rehabilitation Research, St Leonards, New South Wales, Australia"
      ],
      "name": "Lisa A Harvey"
    }
  ],
  "title": "Management of musculoskeletal conditions with remotely delivered physiotherapy versus face-to-face physiotherapy: process evaluation of the REFORM trial using the Realist Evaluation and the RE-AIM Framework",
  "uid": "c999e43d-1eb5-561c-9938-e3dccdeeb753"
}