ACCESSO DIRETTO IN FISIOTERAPIA: IL PAZIENTE CON PROBLEMATICHE MUSCOLOSCHELETRICHE

management of patients with musculoskeletal disorders, through an examination of regulations, economic and clinical matters (effectiveness and patient’s safety). We performed a comparison between direct access and referred care, or other interventions. Materials and methods: We searched the main biomedical databases (i.e. Medline, PEDro, Cochrane Library, EMBASE, CINHAL, Google Scholar) to find literature on legislation, economical aspects, effectiveness and cost-effectiveness of direct access in physical therapy for the management of musculoskeletal disorders. We initiated with a more global analysis (worldwide and Europa) and we moved towards the analysis of a more specific area (Italia and Piedmont). Results: Direct access is an effective, safe and efficient organization model for the management of patients with musculoskeletal disorders. It is more effective than medical-referral approaches and than other interventions, above all regarding the following outcome measures: patient’s satisfaction, numbers of imaging and drugs, lost working days and compliance to the rehabilitation program. Conclusions: Direct access represents a virtuous organization model which can help to increase the global quality of physical therapy provided from the health service. Further studies are necessary to confirm the findings of this professional issue.