Effect and Cost of a Physiotherapy-led Care Model in Emergency Departments for Patients With Minor Musculoskeletal Injuries

Not Applicable

Recruiting

• Conditions: Musculoskeletal Disorders; Emergency Care; Physiotherapy

• Registration Number: NCT07137754
• Lead Sponsor: Aarhus University Hospital

Brief Summary

Both in Denmark and internationally, emergency departments have been overwhelmed for several years by a growing number of patients, combined with a shortage of doctors and nurses. This problem is expected to continue because the number of elderly people with multiple health problems is increasing. To keep providing good quality care in emergency departments, we need to consider new ways of organizing treatment.

In Canada, Australia, and the UK, some hospitals have tried a model where specially trained physiotherapists examine and treat patients who come in with muscle and joint injuries and pain. Since these patients make up about 25% of all those referred to emergency departments, this model could help take some pressure off doctors and nurses. That way, doctors and nurses can spend more time caring for seriously ill patients who need urgent help.

Several studies on these physiotherapist-led models show benefits for both patients and the healthcare system. Patients report being more satisfied and better informed about their injury and treatment. They wait less, have fewer unnecessary tests, and need fewer repeat visits to the emergency department.

However, similar studies have never been done in Scandinavia, even though some Danish emergency departments have tested similar models. Healthcare systems and the education of physiotherapists differ between Scandinavian countries and the countries mentioned above. So, we don't know if we would see the same benefits here. Also, there has been no research on whether this model is cost-effective, which is important for decision-makers when planning future healthcare budgets.

With this research project, we want to test a model in Danish hospitals where specially trained physiotherapists take care of examining, treating, and discharging patients with muscle and joint pain and injuries. We will look at how this model affects patient experiences (like pain and satisfaction) and clinical outcomes (like repeat emergency visits and use of imaging tests), compared to the usual practice where doctors handle these patients. We will also study whether the model is cost-effective, meaning whether the benefits of using this approach are worth the costs, or even greater than the costs.

The study will be conducted at 4-5 hospitals, where a total of 800 patients with minor musculoskeletal injuries will be included in connection with their visit at the emergency department. Patients will receive questionnaires at 1, 4, 12 and 26 weeks after injury regarding patient reported outcomes. Register data will be retrieved at 26 weeks regarding the patients' health care use during follow-up.

Detailed Description

Not available

Study Timeline

• Status Verified: 2025-08
• Study Start: 2025-08-15
• Study First Submitted: 2025-08-15
• Study First Submitted QC: 2025-08-15
• Last Update Submitted: 2025-08-15
• Study First Posted: 2025-08-22
• Last Update Posted: 2025-08-22
• Primary Completion: 2028-03-01
• Study Completion: 2028-03-01

Recruitment & Eligibility

• Status: RECRUITING
• Sex: All
• Target Recruitment: 800

Inclusion Criteria

• Musculoskeletal pain and injury to the upper or lower extremities
• Triaged non-urgent (blue) in the emergency department
• Speaks and understands Danish

Exclusion Criteria

• High velocity trauma
• Cognitively unable to participate
• Non-malignant conditions (cancer, inflammation, infection)

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Primary Outcome Measures

Name	Time	Method
Brief pain inventory short form	From baseline (time of injury) to 12 weeks follow-up	BPI short form is a self-reported questionnaire, using the 7 items pain interference on functional ability, mood, sleep and work. The patient completes the assessment at baseline, 1, 4, 12 and 26 weeks after injury
Euroqol 5 Dimensions 5 Levels	From baseline to 26 weeks	The EQ5D assesses health-related quality of life using 5 items. It is used as the primary outcome for qualculation of QUALYs in the health economic analysis.

Secondary Outcome Measures

Name	Time	Method
Visit-specific satisfaction questionnaire	Is collected at week 1 after baseline	VSQ-9 is a selfreported questionnaire with 9 items on different aspects of patient satisfaction with their visit to the emergency department
PROMIS short form physical function	From baseline to 12 weeks after.	The questionnaire contains 8 questions on limitations in functional ability due to injuries in the lowe extremeties. It is collected via self-reported questionnaires at baseline, weeks 1, 4, 12 and 26 after baseline
PROMIS short form upper extremety	From baseline to 12 weeks	Contains questions about functional limitations due to injuries in the upper extremeties. Measured at baseline, weeks 1, 4, 12 and 26 after discharge
Work Productivity and Activity Impairment	From baseline to 12 weeks	The WPAI measures number of hours missed from work, volunteer work (unpaid work) and studies due to health related issues. Further it measures hours with reduced productivity at work due to health related issues. Assessed at baseline, weeks 1, 4, 12 and 26 using self-reported questionnaires
Return-visits to emergency department	From baseline to 12 week follow-up	Return-visits and phone calls to the emergency department due to the same injury during follow-up, assessed using self-report and register-based data.
Health care use in primary care	From baseline to 26 week follow-up	Includes visits with general practice and physiotherapy practice during follow-up. This will be collected via the National Health Service Register

Trial Locations

Locations (1)

Aarhus University Hospital; 🇩🇰 Aarhus N, Denmark