Task-sharing and Shifting Model for Acute Low Back Pain (LombalgIP)

Grenoble Alpes University Hospital Center (CHU)

Status: Enrolling

Conditions: Low Back Pain

Treatments: Other: Usual care; Other: Task-sharing and shifting model between family physicians and physiotherapists

Study type: Interventional

Funder types: Other

Identifiers

NCT05200533

38RC21.0259

Details and patient eligibility

About

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

Enrollment: 195 estimated patients

Sex: All

Ages: 20 to 55 years old

Volunteers: No Healthy Volunteers

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)

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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195 participants in 2 patient groups

Task-sharing and shifting

Experimental group

Description:

In the task-sharing and shifting group, family physicians shifted acute low back pain consultations to physiotherapists. Patients with acute low back pain are seen by the physiotherapist instead of family physician. Physiotherapist diagnose acute low back pain, identify red and yellow flags, prescribe sick leave and medications and can refer the patient to additional physical therapy treatment.

Treatment:

Other: Task-sharing and shifting model between family physicians and physiotherapists

Usual care

Active Comparator group

Description:

In the usual care group, patients with acute low back pain are seen by their family physician.

Treatment:

Other: Usual care