Skip to main content

Table 5 The impact of waiting for treatment for musculoskeletal conditions on health outcomes

From: Reducing wait time from referral to first visit for community outpatient services may contribute to better health outcomes: a systematic review

Study Outcome MICD Findings (Positive MD favours shorter wait) Statistical Significance Clinical Significance
Amato et al (1997) [45] QOL (FOTO Outcomes Index) Unable to estimate Patients treated within 15 days had greater improvement in QOL ? ?
Patient Satisfaction (FOTO Patient Satisfaction Index) Unable to estimate No association between patient satisfaction and waiting time N N
Linton et al (1993) [49] Pain (Treatment outcome questionnaire) Unable to estimate No sig. difference between groups N N
Workplace participation ≥ 1 day History of MSP: No sig. differences N N
Number of days off work each quarter   No History of MSP:   
   1st Quarter: MD 11 (95%CI 0.01-22.0) Y Y
2nd Quarter: MD 7 (95%CI -2.7-16.7) N N
3rd Quarter: MD 11 (95%CI 2.8-19.2) Y Y
4th Quarter: MD 5 (95%CI -4.7-14.7) N N
Development of chronic symptoms (proportion & RR) Unable to estimate History of MSP: No sig. differences N N
No History of MSP: Short wait 2% vs. long wait 15%, RR 8.2 (95%CI 1.5-45.3) Y ?
Patient Satisfaction (Treatment satisfaction questionnaire) Unable to estimate Short wait group more satisfied with time to appointment (X2=15.8, P<0.01 with history of MSP, X2=9.4, P=0.02 with no history) Y ?
No sig. differences between groups in satisfaction with examination & treatment N N
Nordemann et al (2006) [51] Pain     
 BRPP (change scores) 1.2 units MD 0.10 (95%CI -1.0 to 1.2) N N
 ŐMPSQ (change scores) 11.7 units MD 6.3 (95%CI -8.1 to 20.7) N N
Function: RMQ (change scores) 3.5 units MD -0.9 (95%CI -1.0 to 1.2) N N
Workplace participation: ŐMPSQ (change scores) 1.1 units MD -0.7 (95%CI -1.7 to 1.3) N N
Pedersen et al (2017) [55] Function (SPPB) Unable to estimate G 0.10 (95%CI -0.1 to 0.2) N N
Self et al (2000) [52] Function (TOAS) Unable to estimate No sig. differences between groups. N N
Wand et al (2004) [53] Function (RMQ) 3.5 units MD 1.8 (95%CI -0.4 to 4.0) N N
Pain (VAS) 3.5 units MD 0.9 (95%CI -0.04 to 1.8) N N
Anxiety symptoms (STAIS) 2 units MD 2.8 (95%CI 1.0 to 4.6) Y Y
Depressive symptoms (MZDRS) 5.7 units MD 8.4 (95%CI 3.9 to 12.9) Y Y
 EQ-5D Total Score 0.15 units MD 0.10 (95%CI 0 to 0.2) N N
 SF-36 Physical Function 9.5 units MD 3 (95%CI -4.8 to 10.8) N N
 SF-36 Role-Physical 21.5 units MD 11 (95%CI -6.7 to 28.7) N N
 SF-36 Bodily Pain 11 units MD 11 (95%CI 2.3 to 19.7) Y Y
 SF-36 General Health 9.5 units MD 12 (95%CI 5.2 to 18.8) Y Y
 SF-36 Vitality 10.5 units MD 22 (95%CI 13.7 to 30.3) Y Y
 SF-36 Social Functioning 12.5 units MD 16 (95%CI 6.4 to 25.6) Y Y
 SF-36 Role-Emotional 21.5 units MD 19 (95%CI 2.7 to 35.3) Y N
 SF-36 Mental Health 12 units MD 22 (95%CI 13.5 to 30.5) Y Y
Zigenfus et al (2000) [54] Workplace participation     
 Days away from work ≥ 1 day Short wait vs. intermediate wait:
MD 0.7 (95%CI 0.4 to 1.0)
   Short wait vs. long wait
MD 2.5 (95%CI 2.0 to 3.0)
 Days of restricted work duties ≥ 1 day Short wait vs. intermediate wait MD 1.8 (95%CI 1.3 to 2.3) Y Y
Short wait vs. long waitMD 5.3 (95%CI 4.4 to 6.2) Y Y
  1. MICD Minimum Clinically Important Differences, QOL Quality of Life, FOTO Focus on Therapeutic Outcomes, TOAS Therapeutic Outcomes Assessment System, BRPP Borg Category Scale for Ratings of Perceived Pain, ŐMPSQ Őrebro Musculoskeletal pain Screening Questionnaire, RMQ Roland and Morris disability Questionnaire, Sig Significant, SPPB Short Performance Physical Battery, VAS Visual Analogue Scale, STAIS Spielberger State-trait Anxiety Inventory, MZDRS Modified Zung Self-Rated Depression Score, EQ-5D EuroQOL-5D, SF-36 36-item Short Form Survey, MD Mean Difference, RR Risk Ratio, Y Yes, N No; ? Unable to determine