Back Pain, Communication
Conditions
Keywords
patient-centered-communication, Primary Care, over investigation, communication, consultation, shared-decision making, medical education, low back pain
Brief summary
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
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.
Interventions
OTHERWorkshop ICE training
The workshop includes training in communication skills in relation to evidence based medicine.
Sponsors
German Federal Ministry of Education and Research
University of Erlangen-Nürnberg
University of Erlangen-Nürnberg Medical School
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
TRIPLE (Subject, Caregiver, Outcomes Assessor)
Masking description
All participating doctors will be blinded towards the explicit purpose and design of the study. ICE communication training will be offered to all participants: to the doctors in the intervention group as a true intervention at the beginning of the trial, and to the doctors in the control group as a pretend intervention at the end of the trial.
Intervention 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.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
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
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| number of medical referrals | data collection up to 12 weeks post intervention aims to capture 40 consultations for acute backpain | referrals of patients to physiotherapists and medical specialists such as radiologists, neurologists, orthopedic surgeons |
Countries
Germany
Outcome results
None listed