A Secondary Analysis from the MobilE-TRA Cohort Study (Care Pathways and their Impact on Mobility, Social Participation and Quality of Life in Dizziness and Balance Disorders as well as Joint Deseases)

Background Vertigo, dizziness and balance disorders (VDB) are complex health problems in older people and common reasons to consult the general practitioner (GP). Physiotherapy can have positive impacts on balance and the risk of falls in patients with VDB. The German evidence- and consensus-based guideline "Acute dizziness in general practice" recommends physiotherapy for specific diagnoses. To what extent general GPs physiotherapy prescriptions correspond to the guideline's recommendations is still unknown. There is no data on whether these prescriptions comply with the recommendations of the guideline and to what extent patients actually utilize them.Aim To determine the proportion and rate of utilization of physiotherapy prescribed by GPs in the treatment of older patients with VDB within the MobilE-TRA cohort study and to investigate their compliance with the German guideline.Method The secondary analysis is based on data from the MobilE-TRA cohort study, in which patients aged 65 and over with VDB were examined in 17 GP practices in Bavaria and Saxony. Data collection was from 09/2017-10/2019. The GP's prescriptions due to VDB and the patient's utilization of physiotherapy were examined using validated and self-developed questionnaires. The data were analyzed descriptively and distribution differences were analyzed using Fisher's exact test.Results The sample included 158 patients with VDB. 16 % of the patients received a physiotherapy prescription. In total 14.2 % of physiotherapy prescriptions comply with the recommendations of the guideline. The non-utilization rate of physiotherapy was 32 % (Bavaria 53.8 %; Saxony 8.3 %). There was a significant regional distribution difference (p = 0.030, Phi = 0.487 [95 % CI = 0.129-0.846]).Conclusion With 16 %, the frequency of physiotherapy prescriptions is comparatively high. Since the reasons for non-utilization haven't been recorded, explanations can hardly be given. With regard to both the planning of adherent therapy and the avoidance of differences in care, it would be important to examine the reasons for the non-use of prescribed therapy in the future.