Determining the Impact of a New Physiotherapist Led Primary Care Model for Back Pain

Queen's University

Status: Completed

Conditions: Back Pain

Treatments: Behavioral: Physiotherapist-led primary care model for back pain; Other: Usual care

Study type: Interventional

Funder types: Other

Identifiers

NCT03320148

6021536

Details and patient eligibility

About

This is a pilot cluster randomized controlled trial to determine the feasibility of a cluster randomized trial to evaluate the individual and health system impact of implementing a new physiotherapist-led primary care model for back pain in Canada.

Full description

This study aims to determine the feasibility of conducting a cluster randomized trial in primary care settings in Ontario to evaluate the individual health outcomes and health system impact of implementing a new physiotherapist-led primary care model for people with back pain. The primary purpose of this pilot study is to determine the feasibility including recruitment and retention of primary care teams (sites) and patient participants, carrying out the assessment procedures, and implementing the physiotherapist-led primary care intervention including training the physiotherapist to adopt this role.

Enrollment: 100 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Adults (18 years and over) with back pain of any duration
• Seeking primary care for back pain at a participating site
• Primary care visit may be a first or repeat visit

Exclusion criteria

• Patients who do not consent to participation
• Patients who report being unable to understand, read, and write English

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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100 participants in 2 patient groups

Physiotherapist-led primary care model for back pain

Experimental group

Description:

The PT-led primary care model for back pain will involve incorporating a PT within the primary care team at the first point of contact for people with back pain at no cost to the patient. Patients in this model will be given the choice of seeing the PT or family doctor. They will be encouraged to book with the PT except when the primary reason for visit is for medication renewals or when the patient has additional health concerns that need attention from their physician in the same visit. There will be 4 key components of the PT led primary care intervention: 1) Initial assessment and screening; 2) Brief individualized intervention at the first visit; 3) Health services navigation; 4) Providing additional PT care for people with an unmet need.

Treatment:

Behavioral: Physiotherapist-led primary care model for back pain

Usual care

Active Comparator group

Description:

The physician led primary care intervention will be unstandardized to best reflect standard clinical practice in Canada. This usually includes a visit to a primary care physician, who would perform a history and physical examination, provide LBP education, and prescribe medications and/or refer based on their assessment findings and patient preferences.

Treatment:

Other: Usual care