Extended roles of non-physician health professionals and innovative models of care within Europe: results from a web-based survey

Musculoskeletal Care. 2011 Jun;9(2):93-101. doi: 10.1002/msc.201.


Background and objective: Due to the increasing prevalence of rheumatic diseases, extended roles of non-physician health professionals and innovative models of care may be important options in rheumatology in the future. Extended roles have been pioneered in the UK, Canada, USA and Australia and been found to be effective and safe. However, few data are available about mainland Europe, so the aim of this study was to explore the current status of the extended roles undertaken by health professionals within Europe, and the corresponding models of care used.

Methods: Non-physician health professionals from various European countries were asked to complete a web-based survey using convenience and snowball sampling techniques. Data analysis involved calculating descriptive statistics and frequencies based on the countries where the participants currently worked.

Results: Of the 479 health professionals who filled in the survey, 430 (92%) indicated that they were performing extended roles. Considerable differences between the 27 participating countries existed, in terms of which extended roles and which innovative models of care were being used. Barriers to performing extended roles were cited as the attitude of rheumatologists in all but eight countries, while attitudes of patients were less common barriers. Lack of knowledge, education and educational opportunities were also experienced in several countries.

Conclusion: The present study produced the first data on extended roles for non-physician health professionals and corresponding innovative models of care in rheumatology within Europe. We recommend increasing educational opportunities, as well as developing strategies to limit the barriers experienced.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Allied Health Occupations
  • Delivery of Health Care / organization & administration*
  • Delivery of Health Care / trends
  • Europe
  • Female
  • Health Care Surveys
  • Humans
  • Internet
  • Male
  • Middle Aged
  • Nursing
  • Podiatry
  • Professional Role*
  • Rheumatic Diseases / therapy*
  • Young Adult