We conducted a scoping review to identify and describe the available evidence, or its gaps, on the reasons that guide healthcare professionals to refer patients to physiotherapy for treatment of chronic wounds. More specifically, the literature was analyzed on the referral process as: decision trees or guidelines, inclusion of a selection criteria that guide written referrals and professional more likely to refer patients to physiotherapy in wound care.
This scoping review was designed in accordance with the PRISMA-ScR guidelines and registered in OSF. Medline, Cinahl, Scopus, Pedro and grey literature were screened for studies published in the last 30 years, in adults and chronic wounds only.
Databases search was not limited to any language. After screening, duplicates and conflicts resolved we all studies that presented even partial evidence of a reference process, guidelines or possible actions by physiotherapy.
In order to answer the main research questions, full texts were assessed for:
- the presence of referral process mentions;
- a description of referral or request to physiotherapy;
- a direct or indirect mention of the professionals involved in wound care;
- guidelines or decision trees indicating the referral to physiotherapy;
- physical therapy modalities, type of wounds, types of referral professionals, provenance of patients and time duration of wound, with or without an indication on how the patients were referred to physiotherapy for chronic wound.
A total of 37 studies were included for analysis from the 2432 retrieved on the databases and grey literature, which represented most of the studies included (n=20).
However, none of the studies directly answered our research question on referral practices to physical therapy. We therefore included studies which content provided indicators of physiotherapy referrals, even if the information was fragmentary or incomplete.
The studies focused mainly on one type of chronic and complex wound at a time, as well as on one or more treatment modalities in comparison with the other. A paucity of the selected studies permitted the identification of the professionals who had recruited or referred study participants to physiotherapy.
More detailed data on how to refer to physiotherapy or including physiotherapy referral concepts for chronic and complex wounds was retrieved in grey literature.
This scoping review demonstrated the absence of studies concerning specifically referral practices to physiotherapy in chronic wounds care.
Interestingly, the relevance of referring patients to physiotherapy in chronic wound care is mentioned by clinical guidelines and grey literature. However, the optimal referral practice among professionals remains unexplored.
Ultimately, referral practices likely influence accessibility and outcomes in physiotherapy for wound care. Therefore, attitudes, beliefs and best practices of healthcare professionals who refer patients to physiotherapy in wound care is a research field to be considered.
Referral practices
Interprofessionalism
