Development and Feasibility Testing of an Advanced Practice Physiotherapy Role in Chronic Pain Management

Jordan Miller, PT, PhD

Status: Completed

Conditions: Chronic Pain

Treatments: Behavioral: APP-led model of care for chronic pain management

Study type: Interventional

Funder types: NETWORK; Other

Identifiers

NCT05336903

REH-782-20

Details and patient eligibility

About

The current study is intended to evaluate the feasibility of conducting a future trial to evaluate the effects of implementing an advanced practice physiotherapist (APP) role within a chronic pain clinic setting.

Full description

This line of research ultimately seeks to assess the impact of integrating an APP as the first point of contact within interprofessional chronic pain clinics on patient health outcomes, care provided to patients, chronic pain clinic flow, and cost-utility in comparison to usual physician or nurse practitioner-led care.

The primary objectives of the feasibility study are:

1. To determine the feasibility of implementing the trial methods by evaluating participant recruitment rates, retention, and assessment completion at each of four follow-up time-points over a 12-month period.
2. To determine the feasibility of implementing the new APP model of care by monitoring the care provided and treatment fidelity.
3. To explore the perspectives of participants and health care providers related to the acceptability of the APP role; barriers, facilitators, and strategies for refining implementation; and perceived impact on clinic processes and outcomes.

Enrollment: 45 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion and exclusion criteria

Inclusion Criteria:

• Chronic musculoskeletal pain (pain > 3 months in duration) (e.g., neck pain, thoracic pain, limb pain, low back pain) -OR-
• Chronic widespread pain (e.g., fibromyalgia, myofascial syndrome) -AND-
• 18 years of age or older -AND-
• Must be able to read, write, and speak English

Exclusion Criteria (as identified in referral package):

• Primary reason for referral stated as medication change or interventional pain management (e.g., injections, nerve block)
• Primary reason for referral is stated as headache or migraine.
• Reason for referral is chronic pelvic pain
• Referral includes information that patient has an untreated addiction, mental health disorder, or substance use disorder
• Referral indicates cancer-related pain
• Referral indicates medical "red flags" suggestive of non-musculoskeletal etiology of symptoms (e.g., unexplained symptoms, sudden weight loss, urinary retention, saddle anesthesia, evidence of upper motor neuron lesion, or fever)
• Referral states visceral pain or abdominal pain.

Trial design

Primary purpose: Health Services Research

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

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45 participants in 1 patient group

APP-led model of care for chronic pain management

Experimental group

Description:

The APP-led model of care involves integrating an APP as the first point of contact within an interprofessional chronic pain clinic setting. This is in contrast to the usual physician- or nurse practitioner-led model of care.

Treatment:

Behavioral: APP-led model of care for chronic pain management