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Triaging Patients With Musculoskeletal Disorders Directly to Physiotherapists at Primary Health Care Clinics.

Primary Purpose

Musculoskeletal Disorders

Status
Terminated
Phase
Not Applicable
Locations
Sweden
Study Type
Interventional
Intervention
Initially triaged to physiotherapist
Initially triaged to physician
Sponsored by
Göteborg University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional health services research trial for Musculoskeletal Disorders

Eligibility Criteria

16 Years - 67 Years (Child, Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • seeking primary care clinic for musculoskeletal disorder
  • age 16-67 years
  • speaks enough Swedish or English to understand the patient information and complete the questionnaires
  • triage nurse judges it suitable to triage participant to physiotherapist

Exclusion Criteria:

  • has received treatment at the clinic by physician or physiotherapist during the preceding month for the same problem
  • seeking for chronic musculoskeletal disorder with unchanged symptoms the latest 3 months and for which the patient has already tried physiotherapy
  • seeking for help with medical aids other than crutches
  • is in need of home care
  • has been included in the study earlier

Sites / Locations

  • Närhälsan Eriksberg Health centre
  • Närhälsan Biskopsgården Health centre
  • Närhälsan Kyrkbyn Health centre

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Initially triaged to physiotherapist

Initially triaged to physician

Arm Description

Initially triaged to physiotherapist

Initially triaged to physician

Outcomes

Primary Outcome Measures

Number of physician visits
Change in self-evaluated level of pain latest week (0-10 scale)

Secondary Outcome Measures

Number of physiotherapist visits
Number of days of sick-leave
Number of referrals for external examinations and to specialists
Changes in health-related quality of life measured with EQ-5D
Changes in health-related quality of life measured with EQ-5D
Changes in health-related quality of life measured with EQ-5D
Changes in health-related quality of life measured with EQ-5D
Changes in attitudes regarding responsibility for musculoskeletal disorders measured with ARM scale
Changes in attitudes regarding responsibility for musculoskeletal disorders measured with ARM scale
Changes in attitudes regarding responsibility for musculoskeletal disorders measured with ARM scale
Changes in attitudes regarding responsibility for musculoskeletal disorders measured with ARM scale
Change in experience of functional difficulty measured with DRI scale
Change in experience of functional difficulty measured with DRI scale
Change in experience of functional difficulty measured with DRI scale
Change in experience of functional difficulty measured with DRI scale
Risk for developing chronic pain measured with the Örebro Musculoskeletal Pain Screening Questionnaire
Risk for developing chronic pain measured with the Örebro Musculoskeletal Pain Screening Questionnaire
Risk for developing chronic pain measured with the Örebro Musculoskeletal Pain Screening Questionnaire
Risk for developing chronic pain measured with the Örebro Musculoskeletal Pain Screening Questionnaire
Change in self-evaluated level of pain latest week (0-10 scale)
Change in self-evaluated level of pain latest week (0-10 scale)
Change in self-evaluated level of pain latest week (0-10 scale)
Prescriptions för analgesics for the actual musculoskeletal disorder
Received any prescriptions. Number of prescriptions. Number of occasions prescriptions were received. Type of prescription(s) received.
Prescriptions för analgesics for the actual musculoskeletal disorder
Received any prescriptions. Number of prescriptions. Number of occasions prescriptions were received. Type of prescription(s) received.
Prescriptions för analgesics for the actual musculoskeletal disorder
Received any prescriptions. Number of prescriptions. Number of occasions prescriptions were received. Type of prescription(s) received.
Prescriptions för analgesics for the actual musculoskeletal disorder
Received any prescriptions. Number of prescriptions. Number of occasions prescriptions were received. Type of prescription(s) received.

Full Information

First Posted
August 15, 2014
Last Updated
April 25, 2019
Sponsor
Göteborg University
Collaborators
Närhälsan Primary care Research and Development
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1. Study Identification

Unique Protocol Identification Number
NCT02218749
Brief Title
Triaging Patients With Musculoskeletal Disorders Directly to Physiotherapists at Primary Health Care Clinics.
Official Title
The Effects of Triaging Patients With Musculoskeletal Disorders Directly to Physiotherapists at Primary Health Care Clinics: a Pilot Study and Randomized Controlled Trial.
Study Type
Interventional

2. Study Status

Record Verification Date
April 2019
Overall Recruitment Status
Terminated
Why Stopped
Organizational barriers
Study Start Date
August 2014 (Actual)
Primary Completion Date
March 2018 (Actual)
Study Completion Date
March 2019 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Göteborg University
Collaborators
Närhälsan Primary care Research and Development

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to determine whether initial triaging to physiotherapists of patients with musculoskeletal disorders who seek health care from primary care clinics affects the patients health and/or health care utilization differently than initial consultation with a general practitioner.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Musculoskeletal Disorders

7. Study Design

Primary Purpose
Health Services Research
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
Care ProviderOutcomes Assessor
Allocation
Randomized
Enrollment
55 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Initially triaged to physiotherapist
Arm Type
Experimental
Arm Description
Initially triaged to physiotherapist
Arm Title
Initially triaged to physician
Arm Type
Active Comparator
Arm Description
Initially triaged to physician
Intervention Type
Other
Intervention Name(s)
Initially triaged to physiotherapist
Intervention Type
Other
Intervention Name(s)
Initially triaged to physician
Primary Outcome Measure Information:
Title
Number of physician visits
Time Frame
1 year
Title
Change in self-evaluated level of pain latest week (0-10 scale)
Time Frame
3 months
Secondary Outcome Measure Information:
Title
Number of physiotherapist visits
Time Frame
1 year
Title
Number of days of sick-leave
Time Frame
1 year
Title
Number of referrals for external examinations and to specialists
Time Frame
1 year
Title
Changes in health-related quality of life measured with EQ-5D
Time Frame
2 weeks
Title
Changes in health-related quality of life measured with EQ-5D
Time Frame
3 months
Title
Changes in health-related quality of life measured with EQ-5D
Time Frame
6 months
Title
Changes in health-related quality of life measured with EQ-5D
Time Frame
1 year
Title
Changes in attitudes regarding responsibility for musculoskeletal disorders measured with ARM scale
Time Frame
2 weeks
Title
Changes in attitudes regarding responsibility for musculoskeletal disorders measured with ARM scale
Time Frame
3 months
Title
Changes in attitudes regarding responsibility for musculoskeletal disorders measured with ARM scale
Time Frame
6 months
Title
Changes in attitudes regarding responsibility for musculoskeletal disorders measured with ARM scale
Time Frame
1 year
Title
Change in experience of functional difficulty measured with DRI scale
Time Frame
2 weeks
Title
Change in experience of functional difficulty measured with DRI scale
Time Frame
3 months
Title
Change in experience of functional difficulty measured with DRI scale
Time Frame
6 months
Title
Change in experience of functional difficulty measured with DRI scale
Time Frame
1 year
Title
Risk for developing chronic pain measured with the Örebro Musculoskeletal Pain Screening Questionnaire
Time Frame
2 weeks
Title
Risk for developing chronic pain measured with the Örebro Musculoskeletal Pain Screening Questionnaire
Time Frame
3 months
Title
Risk for developing chronic pain measured with the Örebro Musculoskeletal Pain Screening Questionnaire
Time Frame
6 months
Title
Risk for developing chronic pain measured with the Örebro Musculoskeletal Pain Screening Questionnaire
Time Frame
1 year
Title
Change in self-evaluated level of pain latest week (0-10 scale)
Time Frame
2 weeks
Title
Change in self-evaluated level of pain latest week (0-10 scale)
Time Frame
6 months
Title
Change in self-evaluated level of pain latest week (0-10 scale)
Time Frame
1 year
Title
Prescriptions för analgesics for the actual musculoskeletal disorder
Description
Received any prescriptions. Number of prescriptions. Number of occasions prescriptions were received. Type of prescription(s) received.
Time Frame
2 weeks
Title
Prescriptions för analgesics for the actual musculoskeletal disorder
Description
Received any prescriptions. Number of prescriptions. Number of occasions prescriptions were received. Type of prescription(s) received.
Time Frame
3 months
Title
Prescriptions för analgesics for the actual musculoskeletal disorder
Description
Received any prescriptions. Number of prescriptions. Number of occasions prescriptions were received. Type of prescription(s) received.
Time Frame
6 months
Title
Prescriptions för analgesics for the actual musculoskeletal disorder
Description
Received any prescriptions. Number of prescriptions. Number of occasions prescriptions were received. Type of prescription(s) received.
Time Frame
1 year

10. Eligibility

Sex
All
Minimum Age & Unit of Time
16 Years
Maximum Age & Unit of Time
67 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: seeking primary care clinic for musculoskeletal disorder age 16-67 years speaks enough Swedish or English to understand the patient information and complete the questionnaires triage nurse judges it suitable to triage participant to physiotherapist Exclusion Criteria: has received treatment at the clinic by physician or physiotherapist during the preceding month for the same problem seeking for chronic musculoskeletal disorder with unchanged symptoms the latest 3 months and for which the patient has already tried physiotherapy seeking for help with medical aids other than crutches is in need of home care has been included in the study earlier
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Lena Bornhöft, MSc, RPT
Organizational Affiliation
Göteborg University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Närhälsan Eriksberg Health centre
City
Gothenburg
ZIP/Postal Code
417 64
Country
Sweden
Facility Name
Närhälsan Biskopsgården Health centre
City
Gothenburg
ZIP/Postal Code
418 33
Country
Sweden
Facility Name
Närhälsan Kyrkbyn Health centre
City
Gothenburg
ZIP/Postal Code
418 73
Country
Sweden

12. IPD Sharing Statement

Citations:
PubMed Identifier
31043169
Citation
Bornhoft L, Thorn J, Svensson M, Nordeman L, Eggertsen R, Larsson MEH. More cost-effective management of patients with musculoskeletal disorders in primary care after direct triaging to physiotherapists for initial assessment compared to initial general practitioner assessment. BMC Musculoskelet Disord. 2019 May 1;20(1):186. doi: 10.1186/s12891-019-2553-9.
Results Reference
derived

Learn more about this trial

Triaging Patients With Musculoskeletal Disorders Directly to Physiotherapists at Primary Health Care Clinics.

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