Low Back Pain
Conditions
Keywords
Task-sharing, Task-shifting, Family physician, Physiotherapist
Brief summary
Background: The aging population and the rising prevalence of musculoskeletal disorders increase resort to primary care services. Models of care integrating task sharing and shifting (TS/S) can help face challenge of access to care by strengthening the role of healthcare professionals. In France, a new TS/S model is being implemented between family physicians (FPs) and physiotherapists (PTs) for acute low back pain (LBP) patients' care. The aim of this study is to evaluate the effect of this new model of care on patient clinical outcomes, healthcare resources use and patient satisfaction. Design: Pragmatic cluster randomized controlled trial
Interventions
OTHERTask-sharing and shifting model between family physicians and physiotherapists
Medical consultations for acute low back pain patients are shifted from family physicians to physiotherapists.
OTHERUsual care
Medical consultations for acute low back pain patients are performed by family physicians
Sponsors
TIMC-IMAG
University Hospital, Grenoble
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Masking description
Data analysis will be blinded.
Intervention model description
Cluster randomized controlled trial
Eligibility
Sex/Gender
ALL
Age
20 Years to 55 Years
Healthy volunteers
No
Inclusion criteria
* Patients from 20 to 55 years old * Suffering from acute low back pain since less than 4 weeks * Able to understand and speak French * Whose family physician is included in the task-sharing and shifting model (only in the intervention group)
Exclusion criteria
* Protected patient according to the public health regulation, * Patient unable to fill the survey, * Non-availability of the physiotherapist to receive the patient (only in the intervention group)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Effect of the TS/S model on acute low back pain (LBP) patients' disability at 6 weeks | 6 weeks after the initial consultation | Rolland Morris Disability Questionnaire It is a 24 points scale. The lower score is 0, the higher score is 24. Higher scores mean worse outcomes as the disability level is higher. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Effect of the TS/S model on acute LBP patient's pain at 6 weeks and 3 months | 6 weeks and 3 months after the initial consultation | Brief Pain Inventory It is a 10 points scale. Scores rank from 0 to 10. Higher scores mean worse outcomes, as the pain level is higher. |
| Effect of the TS/S model on acute LBP patient's psychosocial risk factors at 6 weeks and 3 months | 6 weeks and 3 months after the initial consultation | Start-Back screening tool It is a 9 points scale. Scores rank from 0 to 9. Higher scores mean worse outcomes. |
| Effect of the TS/S model on acute LBP patients' disability at 3 months | 3 months after the initial consultation | Rolland Morris Disability Questionnaire It is a 24 points scale. Scores rank form 0 to 24. Higher scores mean worse outcomes as the disability level is higher. |
| Effect of the TS/S model on acute LBP patient's wait time before the initial consultation | Initial consultation | Time (number of days and hours) |
| Effect of the TS/S model on healthcare resources use | Initial consultation, 6 weeks and 3 months after the initial consultation | Initial prescription of sick leave and medications, number of family physician visits, number of physical therapy appointments, number of emergency department visits at 6 weeks and 3 months |
| Effect of the TS/S model on acute LBP patient's satisfaction | Few minutes after the initial consultation (less than one hour) | Medrisk questionnaire It is a 5 points scale. Scores rank from 0 to 5. Higher scores mean better outcomes; |
Countries
France
Contacts
Primary ContactAmelie Kechichian, PhD student
Backup ContactAida Mandzo
Outcome results
None listed