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

Study Overview
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Brief Summary
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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.

Official Title
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The Effects of Triaging Patients With Musculoskeletal Disorders Directly to Physiotherapists at Primary Health Care Clinics: a Pilot Study and Randomized Controlled Trial.

Conditions
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Musculoskeletal Disorders

Intervention / Treatment
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* Other: Initially triaged to physiotherapist
* Other: Initially triaged to physician


Participation Criteria
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Eligibility Criteria
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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

Ages Eligible for Study
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Minimum Age: 16 Years
Maximum Age: 67 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Initially triaged to physiotherapist<br>Initially triaged to physiotherapist | Other: Initially triaged to physiotherapist<br> <br> |
| Active Comparator: Initially triaged to physician<br>Initially triaged to physician | Other: Initially triaged to physician<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of physician visits |  | 1 year | 
| Change in self-evaluated level of pain latest week (0-10 scale) |  | 3 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of physiotherapist visits |  | 1 year | 
| Number of days of sick-leave |  | 1 year | 
| Number of referrals for external examinations and to specialists |  | 1 year | 
| Changes in health-related quality of life measured with EQ-5D |  | 2 weeks | 
| Changes in health-related quality of life measured with EQ-5D |  | 3 months | 
| Changes in health-related quality of life measured with EQ-5D |  | 6 months | 
| Changes in health-related quality of life measured with EQ-5D |  | 1 year | 
| Changes in attitudes regarding responsibility for musculoskeletal disorders measured with ARM scale |  | 2 weeks | 
| Changes in attitudes regarding responsibility for musculoskeletal disorders measured with ARM scale |  | 3 months | 
| Changes in attitudes regarding responsibility for musculoskeletal disorders measured with ARM scale |  | 6 months | 
| Changes in attitudes regarding responsibility for musculoskeletal disorders measured with ARM scale |  | 1 year | 
| Change in experience of functional difficulty measured with DRI scale |  | 2 weeks | 
| Change in experience of functional difficulty measured with DRI scale |  | 3 months | 
| Change in experience of functional difficulty measured with DRI scale |  | 6 months | 
| Change in experience of functional difficulty measured with DRI scale |  | 1 year | 
| Risk for developing chronic pain measured with the Örebro Musculoskeletal Pain Screening Questionnaire |  | 2 weeks | 
| Risk for developing chronic pain measured with the Örebro Musculoskeletal Pain Screening Questionnaire |  | 3 months | 
| Risk for developing chronic pain measured with the Örebro Musculoskeletal Pain Screening Questionnaire |  | 6 months | 
| Risk for developing chronic pain measured with the Örebro Musculoskeletal Pain Screening Questionnaire |  | 1 year | 
| Change in self-evaluated level of pain latest week (0-10 scale) |  | 2 weeks | 
| Change in self-evaluated level of pain latest week (0-10 scale) |  | 6 months | 
| Change in self-evaluated level of pain latest week (0-10 scale) |  | 1 year | 
| 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. | 2 weeks | 
| 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. | 3 months | 
| 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. | 6 months | 
| 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. | 1 year |