PT-led Triage in Secondary Care Settings for Patients With Hip or/and Knee Osteoarthritis
试验速览
- 阶段
- 不适用
- 状态
- 进行中（未招募）
- 发起方
- 入组人数
- 675
- 试验地点
- 2
- 主要终点
- Short form of the Quality from Patients Perspective (QPP)
研究概览
简要总结
The aim of this project is to compare PT-led triage in secondary care setting for patients with hip or/and knee osteoarthritis (OA) with standard care (i.e. assessment of orthopedic surgeon). Comparison between cost-effectiveness, selection accuracy, patients perceived quality of care, quality of life and physical function will be made.
A further aim is to explore patients expectations and experiences of PT-led triage in a secondary care setting.
详细描述
Osteoarthritis (OA) is a common musculoskeletal disorder and the number of people in need of surgical treatment for hip and knee OA is increasing. The waiting time for consultation with an orthopedic surgeon (OS) is long and the majority of the patient referred for assessment are not appropriate for surgical intervention. To reduce the number of patients seen by an OS and thereby shorten the waiting time, Sahlgrenska University Hospital started a Physiotherapist-led (PT-led) triage project in 2017. With PT-led triage the patients are assessed by a physiotherapist to establish the most appropriate care management; if the patient is appropriate for surgery, should be referred for continued rehabilitation, or referred back to the referring physician. To our knowledge this model of care with PT-led triage in secondary care setting have not been scientifically evaluated in Sweden.
The aim of this project is to compare PT-led triage in a secondary care setting with standard care (i.e. assessment of OS for patients with knee or /and hip OA). A further aim is to determine if a digital triage tool can accurately predict when a primary knee or hip referral is deemed for nonsurgical versus surgical intervention by the surgeon following the first consultation.
Patients referred from primary care to Sahlgrenska University hospital with primary hip and/or knee OA will be included and randomized to consultation with either PT (triage) or OS (standard practice). Data about patient reported health-related quality of life, pain, function, and patients' perception of quality of care will be collected using questionnaires at baseline, 3 and 12 months after the consultation.
Data about waiting time for consultation, proportion of patients appropriate for surgery, further investigations, and data to be able to perform cost analysis will be collected from patients´ journals, the patient administration systems, both locally and via the region Västra Götaland´s database (VEGA).
A qualitative approach will be used to further investigate patients expectations and experience of a PT-led trige.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Health Services Research
- 盲法
- None
盲法说明
Due to the design of the study, it is not possible to blind either caregivers or participants regarding group distribution
入排标准
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Referred to Sahlgrenska University hospital
- •Primary osteoarthritis in the hip or knee
- •Understanding and speaking Swedish
排除标准
- •Prior assessment by and referral from an orthopedic surgeon for the current problem
- •Secondary osteoarthritis (posttraumatic osteoarthritis, femoral head necrosis), when stated on the referral
- •Referred to a specific surgeon
结局指标
主要结局
Short form of the Quality from Patients Perspective (QPP)
时间窗: Baseline
A Measure of patients' perception of quality of care regarding four dimensions: caregivers' medical-technical competence; care organizations' physical-technical conditions; degree of identity-orientation in the caregivers' attitudes and actions; and the care organizations' socio-cultural atmosphere
次要结局
- Pain Disability index (PDI(Baseline, 3 and 12 months)
- Oxford Hip/Knee Score (OHS/OHK(Basline, 3 and 12 months)
- Heath-related quality of life - EuroQol (EQ5-D)(Baseline, 3 and 12 months)
- Forgotten Joint Score (FJS)(Basline, 3 and 12 months)
研究者
Maziar Mohaddes Ardebili
MD Doctor
Sahlgrenska University Hospital