None listed
Conditions
Brief summary
Annually in Dunedin ACC covers care for about 1500 patients with musculoskeletal injuries. These patients are currently referred to the orthopaedic surgeon for assessment, investigation, and/or surgical treatment. About 33% ultimately have orthopaedic surgery. The remaining 67% receive care that could be delivered by GPs with access to appropriate resources (e.g. MRI and CT scans) and training in advanced primary care procedures (e.g. joint injection). Waiting times from referral by their GP to first assessment by orthopaedic surgeons currently average 13 weeks. Earlier assessment and/or intervention by a GP with a special interest in orthopaedics (GPSI) may reduce the time patients wait until they have definitive treatment and thereby reduce their time to functional recovery. Alternatively, GPSI care may simply delay needed orthopaedic surgical intervention. The GPSI programme is new to New Zealand. We propose to study its introduction in Dunedin. The study will not alter the processes already established to manage appropriate care for patients with orthopaedic injuries EXCEPT by randomising the first 110 eligible patients to Usual Care or GPSI care. Most study data will come from data routinely collected on ACC forms and in patient records.
Interventions
Advanced injury care by a GP with a Special Interest (GPSI) and advanced training in musculoskeletal injury care. Duration of the intervention is until resolution of the injury or up to 6 months from trial entry.
Sponsors
South Link health Inc
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1.Adult Dunedin residents affected by an orthopaedic injury covered by ACC, who would normally be referred by their general practitioners to an orthopaedic surgeon where the referral is not Immediate or Urgent as outlined in the National Access Criteria for First Assessment, February 2001.2. Patients who consent to participate in the study and agree to be randomised to either GPSI or normal care.
Exclusion criteria
1. Patients unable or unwilling to consent to participate in the study on their own behalf. 2. Registered patients who normally receive all their general practice care from the four Dunedin GPSIs. 3.Dunedin residents affected by an injury covered by ACC, where the referral to an orthopaedic surgeon is Immediate or Urgent as outlined in the National Access Criteria for First Assessment, February 2001. 4. Dunedin residents affected by an injury covered by ACC, whose care would normally be entirely managed by their general practitioner or another primary care provider.
Outcome results
None listed