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Pain Navigator Tool for Self-management in Back Pain: PATiENCe Trial

Withdrawn
Conditions
Communication
Chronic Low-back Pain
Self Efficacy
Therapeutic Alliance
Interventions
Behavioral: Pain Navigator Tool
Registration Number
NCT04007822
Lead Sponsor
Glasgow Caledonian University
Brief Summary

This study explores the experience of physiotherapists and patients using the Pain Navigator Tool during outpatient musculoskeletal consultations.

Detailed Description

Chronic pain is the largest cause of disability globally and affects up to 28 million people in the UK alone. Nearly half of those who experienced chronic pain in Europe reported receiving insufficient pain management. Conventional treatments commonly used in physiotherapy continue to show only moderate effects in pain management. A potential avenue to improve the global effect of treatments may lie in exploring non-specific treatment moderators such as the therapeutic alliance (TA). Findings suggest that it is linked with engagement in rehabilitation and is a strong predictor of treatment outcomes and adherence. This study aims to evaluate and compare the quality of practice with or without the Pain Navigator Tool (PNT). Understanding the impact of the PNT on therapeutic alliance would open an avenue to improve chronic pain management, reduce healthcare-related expenses and increase the quality of life in the population studied. In addition, exploring the experience of the physiotherapists with using the PNT will provide an in-depth understanding of its use and applicability in similar settings.

The aims of this study are to:

1. To evaluate and compare the quality of practice with or without the PNT in patients with chronic low-back.

2. To collect preliminary data on the usability and practicality of the PNT for physiotherapists.

Recruitment & Eligibility

Status
WITHDRAWN
Sex
All
Target Recruitment
Not specified
Inclusion Criteria

Patient:

  • Participant aged >18 years
  • Low-back pain for more than three months
  • Able to read and speak English to a level allowing satisfactory completion of the study procedures
  • Initial appointment with a participating physiotherapist

Physiotherapist:

  • 2 years of experience in treating patients with chronic pain
  • Currently working in an MSK outpatient clinic
  • Able to read and speak English to a level allowing satisfactory completion of the study procedures
Exclusion Criteria

Patient:

  • Low-back pain is not the primary reason for physiotherapy appointment
  • Return appointment with physiotherapist

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
PhysiotherapistsPain Navigator ToolPhysiotherapists will be recruited using the following inclusion criteria: (1) two years of experience in treating patients with chronic pain, (2) currently working in an MSK outpatient clinic and (3) able to read and speak English to a level allowing satisfactory completion of the study procedures. There are no exclusion criterium. Potential participants will be recruited through the relevant gatekeeper. The gatekeeper will be responsible of forwarding the participant information sheet and consent form to the physiotherapists. Physiotherapists will be asked to demonstrate their interest by replying to the email. Any questions will be answered by the research team via email or phone.
Primary Outcome Measures
NameTimeMethod
Semi-Structured Interview4 weeks

Semi-structured interviews with the participating physiotherapists will explore the experience using the PNT.

Change in the Health Care Providers Pain and Impairment Relationship Scale0 weeks, 4 weeks and at 1 month follow-up

The HC-PAIRS is selected to assess the pain-related attitudes and beliefs of physiotherapists. It is a validated tool with adequate psychometric properties and has already been used in the selected population. It measures attitudes and beliefs on a scale of 13 to 91 with higher scores on this scale indicating stronger beliefs that LBP validates disability.

The Pain Self-Efficacy Questionnaire4 weeks

The PSEQ is selected to capture the patients' levels of confidence in carrying out day-to-day tasks despite the presence of pain. It assesses the confidence of people with any type of chronic pain in activity despite pain. It covers enjoying activities, household daily activities, social life, coping in general, work, leisure activities, coping with pain without medication, accomplishing goals, living a normal lifestyle, and becoming more active, all 'despite pain'. Each is rated on a 7 point scale from 0 = not at all confident to 6 = completely confident. The total score, ranging from 0 to 60, is calculated by adding the scores for each item. Higher scores reflect stronger self-efficacy beliefs.

Secondary Outcome Measures
NameTimeMethod
Change in the Pain Understanding and Confidence Questionnaire0 weeks, 4 weeks and at 1 month follow-up

The PUnCQ is a two-part questionnaire assessing students' knowledge and understanding of pain alongside their confidence in applying this understanding. The questionnaire consists of a chronic pain case vignette, with the first set of questions consisting of a 12-item multiple choice questionnaire, assessing knowledge and understanding in the context of the vignette. The second part of the tool is a 21-item Likert scale ranging from "not at all confident" (0) to "no problem!" (10), with a higher score indicating a higher self-perceived confidence in applying this understanding. Correct answers in the Understanding section were awarded a score of 1, and incorrect a score of 0, with a total accumulated to give a score for each participant.

Trial Locations

Locations (1)

Glasgow Caledonian university

🇬🇧

Glasgow, Strathcylde, United Kingdom

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