Clinical trial NCT02218749: 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
Overall status: TERMINATED
Phase: NA
Conditions: Musculoskeletal Disorders
Lead sponsor: Göteborg University
Sponsor class: OTHER
Collaborators: name: Närhälsan Primary care Research and Development
First posted: 2014-08-18
Enrollment: 55
Sex: ALL
Minimum age (years): 16
Maximum age (years): 67
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: HEALTH_SERVICES_RESEARCH

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.


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

Primary outcomes:
measure: Number of physician visits
timeFrame: 1 year
measure: Change in self-evaluated level of pain latest week (0-10 scale)
timeFrame: 3 months
Secondary outcomes:
measure: Number of physiotherapist visits
timeFrame: 1 year
measure: Number of days of sick-leave
timeFrame: 1 year
measure: Number of referrals for external examinations and to specialists
timeFrame: 1 year
measure: Changes in health-related quality of life measured with EQ-5D
timeFrame: 2 weeks
measure: Changes in health-related quality of life measured with EQ-5D
timeFrame: 3 months
measure: Changes in health-related quality of life measured with EQ-5D
timeFrame: 6 months
measure: Changes in health-related quality of life measured with EQ-5D
timeFrame: 1 year
measure: Changes in attitudes regarding responsibility for musculoskeletal disorders measured with ARM scale
timeFrame: 2 weeks
measure: Changes in attitudes regarding responsibility for musculoskeletal disorders measured with ARM scale
timeFrame: 3 months
measure: Changes in attitudes regarding responsibility for musculoskeletal disorders measured with ARM scale
timeFrame: 6 months
measure: Changes in attitudes regarding responsibility for musculoskeletal disorders measured with ARM scale
timeFrame: 1 year
measure: Change in experience of functional difficulty measured with DRI scale
timeFrame: 2 weeks
measure: Change in experience of functional difficulty measured with DRI scale
timeFrame: 3 months
measure: Change in experience of functional difficulty measured with DRI scale
timeFrame: 6 months
measure: Change in experience of functional difficulty measured with DRI scale
timeFrame: 1 year
measure: Risk for developing chronic pain measured with the Örebro Musculoskeletal Pain Screening Questionnaire
timeFrame: 2 weeks
measure: Risk for developing chronic pain measured with the Örebro Musculoskeletal Pain Screening Questionnaire
timeFrame: 3 months
measure: Risk for developing chronic pain measured with the Örebro Musculoskeletal Pain Screening Questionnaire
timeFrame: 6 months
measure: Risk for developing chronic pain measured with the Örebro Musculoskeletal Pain Screening Questionnaire
timeFrame: 1 year
measure: Change in self-evaluated level of pain latest week (0-10 scale)
timeFrame: 2 weeks
measure: Change in self-evaluated level of pain latest week (0-10 scale)
timeFrame: 6 months
measure: Change in self-evaluated level of pain latest week (0-10 scale)
timeFrame: 1 year
measure: Prescriptions för analgesics for the actual musculoskeletal disorder
timeFrame: 2 weeks
measure: Prescriptions för analgesics for the actual musculoskeletal disorder
timeFrame: 3 months
measure: Prescriptions för analgesics for the actual musculoskeletal disorder
timeFrame: 6 months
measure: Prescriptions för analgesics for the actual musculoskeletal disorder
timeFrame: 1 year
Other outcomes:
Locations:
city: Gothenburg
country: Sweden
facility: Närhälsan Eriksberg Health centre
city: Gothenburg
country: Sweden
facility: Närhälsan Biskopsgården Health centre
city: Gothenburg
country: Sweden
facility: Närhälsan Kyrkbyn Health centre
Study officials:
affiliation: Göteborg University
name: Lena Bornhöft, MSc, RPT
role: PRINCIPAL_INVESTIGATOR
References:
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.