Ideas, Concerns, Expectations. Implementing Patient-centered Communication

Study Overview
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Brief Summary
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Exploring patients' ideas, concerns and expectation (ICE) is a communication tool to promote patient centredness and shared decision making during a consultation. This study evaluates whether offering ICE training to doctors can decrease overdiagnosis in the management of acute backache.

Detailed Description
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The study is a cluster randomized trial recruiting general practitioner from practices in Northern Bavaria/Germany forming a research network within the recently implemented framework of PRO PRICARE (Preventing Overdiagnosis in Primary Care). At baseline, the intervention group (24 out of 48 doctors) will take part in a one-day training session covering theoretical background and clinical implementation of ICE communication in association with frequent consultation contents. Primary outcome measure are referrals to physiotherapists and medical specialists such as orthopaedic surgeons, neurologists and radiologists, obtained from routinely collected practice data. Secondary outcomes are patients' and doctors' satisfaction measured via structured questionnaires and semi-structured interviews. Blinding is attempted by hiding the trial purpose and treatment allocation from the participating doctors.

Official Title
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ICE - Ideas, Concerns, Expectations. Implementing Patient-centered Communication to Prevent Unnecessary Medicine

Conditions
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Communication, Back Pain

Intervention / Treatment
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* Other: Workshop ICE training


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: aged 18 first time seeing doctor because of the defined high frequent consultation issue referring on recommendation of the National Guideline Exclusion Criteria: not first time seeing the doctor during the recommended time of the National Guideline

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Cluster randomised parallel design: Randomization to ICE communication training will take place at the practice level with units of randomizations being single handed or group practices.
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Intervention Group<br>The Intervention Group is allocated to a Workshop of communication training before data collection covering theoretical background and clinical implementation of ICE communication in association with frequent consultation contents. | Other: Workshop ICE training<br>* The workshop includes training in communication skills in relation to evidence based medicine.<br>|
| No Intervention: Control Group<br>This group will not get the intervention before data collection. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| number of medical referrals | referrals of patients to physiotherapists and medical specialists such as radiologists, neurologists, orthopedic surgeons | data collection up to 12 weeks post intervention aims to capture 40 consultations for acute backpain | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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patient-centered-communication, Primary Care, over investigation, communication, consultation, shared-decision making, medical education, low back pain