Clinical trial NCT02265172: Physiotherapy Assessment of Patients Referred to Orthopaedic Surgeon
Official title: Does Orthopaedic Manual Therapy Assessment of Patients Referred to Orthopaedic Surgeon Bring Any Changes to Referral Routines, Patient Satisfaction and Health-related Variables?
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Musculoskeletal Pain
Keywords: Physiotherapy
Orthopaedic
Primary care
Lead sponsor: Vastra Gotaland Region
Sponsor class: OTHER_GOV
First posted: 2014-10-15
Enrollment: 208
Sex: ALL
Minimum age (years): 18
Maximum age (years): 67
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: DIAGNOSTIC

Brief summary: Many patients with musculoskeletal pain in primary healthcare are referred to orthopaedic surgeon, however, a relatively low percentage of these patients are considered suitable for orthopaedic intervention.

Physiotherapists are suitable for musculoskeletal assessments and are used as such in many countries i.e. Advanced Practice Physiotherapists or Extended Scope Physiotherapists, however, this is not an existing model of care in Sweden. To be able to consider this model for implementation in Sweden it is necessary to evaluate it from a healthcare as well as from a patient perspective.

The study is a randomised controlled trial. Overall aim is to evaluate if a orthopaedic manual therapy assessment (physiotherapy) assessment of patients referred to orthopaedic surgeon bring any changes to referral routines, patient satisfaction and health-related variables when compared to standard practice.

Detailed description: The study is a randomised controlled trial. Overall aim is to evaluate if a orthopaedic manual therapy assessment (physiotherapy) assessment of patients referred to orthopaedic surgeon bring any changes to referral routines, patient satisfaction and health-related variables when compared to standard practice. Patients were randomised to either physiotherapy assessment or standard practice (orthopaedic surgeon assessment).

Eligibility criteria: Inclusion Criteria:

* patients referred for orthopaedic surgeon with sub acute (four weeks to three months) or chronic (\>three months) musculoskeletal pain who had the ability to understand written and spoken Swedish.

Exclusion Criteria:

* diagnosed hallux valgus, ganglion or trigger finger.

Primary outcomes:
measure: Number of referrals after consultation as a measure of Management outcome
timeFrame: 12 months
Secondary outcomes:
measure: Scores on the questionnaire Quality from the Patient Perspective as a measure of Patient satisfaction
timeFrame: 30 days
measure: Scores on the EuroQol-5D as a measure of Health-related quality of life
timeFrame: 12 months
measure: Scores on the Pain Disability Index as a measure of Pain-related disability
timeFrame: 12 months
measure: Number of sick-leave days
timeFrame: 12 months
measure: Cost per quality adjusted life year (QUALY) gained as a measure of cost-utitily
timeFrame: 12 months
measure: Scores on the Pain Belief Screening Instrument as a measure of risk for long-term disability
timeFrame: 12 months
Other outcomes:
Locations:
Study officials:
affiliation: Närhalsan Research and development, Region of Västra Götaland
name: Maria Larsson, PhD
role: STUDY_DIRECTOR
References:
citation: Samsson K, Larsson ME. Physiotherapy screening of patients referred for orthopaedic consultation in primary healthcare - a randomised controlled trial. Man Ther. 2014 Oct;19(5):386-91. doi: 10.1016/j.math.2013.10.004. Epub 2013 Oct 29.
citation: Samsson KS, Larsson ME. Physiotherapy triage assessment of patients referred for orthopaedic consultation - Long-term follow-up of health-related quality of life, pain-related disability and sick leave. Man Ther. 2015 Feb;20(1):38-45. doi: 10.1016/j.math.2014.06.009. Epub 2014 Jul 15.
citation: Samsson KS, Bernhardsson S, Larsson ME. Perceived quality of physiotherapist-led orthopaedic triage compared with standard practice in primary care: a randomised controlled trial. BMC Musculoskelet Disord. 2016 Jun 10;17:257. doi: 10.1186/s12891-016-1112-x.