Investigation of a Physiotherapist and Nurse Practitioner Intervention for Chronic Low Back Disorders Delivered Through Telehealth

University of Saskatchewan

Status: Completed

Conditions: Chronic Low Back Pain

Treatments: Other: Interprofessional Videoconferencing for Chronic Low Back Pain; Other: PT face to face management of Chronic Low Back Pain; Other: NP face to face management of Chronic Low Back Pain

Study type: Interventional

Funder types: Other

Identifiers

NCT02225535

Bio13-241

Details and patient eligibility

About

The purpose of this project is to compare "usual care" for chronic low back disorders in a rural setting (nurse practitioner/NP) to two different means of integrating Physical Therapy (PT) into a rural health care team:

1. in-person PT assessment, where the PT travels from an urban center
2. interprofessional Telehealth assessment where the local NP is joined by a PT via Telehealth.

The project will evaluate health, systems and process outcomes, comparative effectiveness and costs of the three methods of assessment. The hypothesis is that an interprofessional Telehealth assessment with be as effective as an in-person PT assessment, but more effective than usual care.

Full description

The study design will include two intervention groups and a control group with 20 participants in each group: 1. interprofessional videoconferencing intervention, 2. in-person PT and, 3. "usual-care" provided by a NP. Due to the interprofessional nature of the intervention, the NP involved in the telehealth-based intervention group may alter their "usual care" practice; therefore, the control group participants will be drawn from the practices of 2 NPs not involved in the Telehealth intervention providing services out of a different clinic. Each PT and the NP alone will complete a standardized online diagnostic classification tool.Participants will be randomly assigned to one of the three groups.

Enrollment: 64 patients

Sex: All

Ages: 18 to 80 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• adult 18-80
• low back pain and/or related leg pain affecting function, >3 months duration

Exclusion criteria

• clients within a third party payer insurance coverage system
• clients with primarily neck or thoracic pain
• clients with language or comprehension difficulties that would limit completion of paperwork

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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64 participants in 3 patient groups, including a placebo group

Usual Care (NP)

Placebo Comparator group

Description:

Rural NP with client in-person, usual care

Treatment:

Other: NP face to face management of Chronic Low Back Pain

PT in-person

Active Comparator group

Description:

Urban PT travels to rural area to manage patient's back pain in-person.

Treatment:

Other: PT face to face management of Chronic Low Back Pain

PT/NP Telehealth

Active Comparator group

Description:

Intervention: Rural NP is joined by PT via Telehealth for interprofessional videoconference with patient

Treatment:

Other: Interprofessional Videoconferencing for Chronic Low Back Pain