Clinical trial NCT00902642: What is the Effect of a Course for Treatment Providers on Their Patient Outcome
Official title: Does Training in Psychosocial Methods for Treatment Providers Improve Outcome for Pain Patients at Risk of Long-Term Disability? A Randomised Controlled Trail of a Course for Physical Therapists
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Pain
Keywords: Physical therapy,
musculoskeletal pain,
psychosocial factors,
dissimilation,
evidence based,
education
Lead sponsor: Örebro County Council
Sponsor class: OTHER_GOV
Collaborators: name: Örebro University, Sweden
name: School of Law, Psychology, and Social Work, Örebro University, Sweden
First posted: 2009-05-15
Enrollment: 364
Sex: ALL
Minimum age (years): 18
Maximum age (years): 65
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: CROSSOVER
Primary purpose: TREATMENT

Brief summary: The goal is to acquire more in-depth knowledge on physical therapists' attitudes towards and beliefs about psychosocial factors in back pain, how physical therapists integrate psychosocial factors into their clinical practice and the effects of a training program for physical therapists in psychosocial factors on clinical practice and thereby on patient outcome in terms of disability, pain, catastrophizing, and treatment satisfaction.

Detailed description: Neck and back pain continue to be extremely common, with a high prevalence and wide socio-economic consequences all over the industrialized world. Through the years a growing interest has risen for other factors than the pure biomedical or biomechanical. This has led to a new clinical model for the treatment of back pain; the biopsychosocial model of illness. Treatment based on the biopsychosocial model not only must address the biological basis of symptoms, but must incorporate the full range of social and psychological factors that have been shown to affect pain, distress and disability.

Since there is today strong evidence indicating that psychosocial factors have a greater impact on disability then biomechanical or biomedical factors and strong evidence that psychosocial factors are strongly linked to the transition from acute to chronic pain, concept of psychosocial risk factors has been developed. Although the concept of psychosocial risk factors still is relatively new, there seems to be an international consensus about the importance of psychosocial risk factors for the prevention of the development of chronic pain but there appears to be considerable uncertainty about the clinical application.

Health care providers' (HCPs') attitudes and beliefs appear to influence the information they provide to patients. This may subsequently result in different patient outcome depending on the HCPs' attitudes and beliefs. Physical therapists attitudes and beliefs are relatively unexplored but seem to have an effect on patients' attitudes and beliefs, which can affect patient outcome in terms of sick leave, health care use and function.

HCP attitudes and beliefs towards psychosocial factors are relatively unexplored. Yet, it seems physical therapists do not necessarily accept new evidence-based information and may have difficulties in applying evidence-based information in their clinical practice. Implementation and dissemination of evidence-based psychosocial factors requires favourable attitudes, knowledge and skills to ensure a behavioural change on behave of the physical therapists.

Eligibility criteria: Inclusion Criteria:

* Musculoskeletal pain,
* Age between 18 and 65

Exclusion Criteria:

* Sick leave for more than 3 months during the past year as a result of present the musculoskeletal pain problem

Primary outcomes:
measure: Disability
timeFrame: treatment start and 6 month follow up
Secondary outcomes:
measure: catastrophizing
timeFrame: treatment start and 6 month follow up
measure: treatment satisfaction
timeFrame: 6 month follow up
measure: satisfaction with treatment result
timeFrame: 6 month follow up
measure: Pain
timeFrame: treatment start and 6 month follow up
Other outcomes:
Locations:
city: Eskilstuna
country: Sweden
facility: Mälardalens högskola
Study officials:
affiliation: Center for Health and Medical Psychology and School of Law, Psychology, and Social Work, Örebro University, Sweden
name: Steven J Linton, PH.D.
role: STUDY_DIRECTOR
References:
citation: Overmeer T, Boersma K, Denison E, Linton SJ. Does teaching physical therapists to deliver a biopsychosocial treatment program result in better patient outcomes? A randomized controlled trial. Phys Ther. 2011 May;91(5):804-19. doi: 10.2522/ptj.20100079. Epub 2011 Mar 30.