Impacts of an Advanced Practice Physiotherapy Model of Care for Adults With a Peripheral Musculoskeletal Disorders Referred to an Orthropaedic Outpatient Clinic

Recruiting

• Conditions: Musculoskeletal Disorders
• Interventions: Other: Advanced practice physiotherapy and orthopedic surgeon management; Other: Orthopedic surgeon management

• Registration Number: NCT05714332
• Lead Sponsor: Ciusss de L'Est de l'Île de Montréal

Brief Summary

The goal of this prospective observational study is to evaluate advanced practice physiotherapy and orthopedic surgeon care and clinical outcomes for new patients with a peripheral musculoskeletal disorders consulting at the orthopedic outpatient clinic of the Hôpital Jean-Talon.

The main questions it aims to answer are: 1. To describe the models of care at the Hôpital Jean-Talon orthopedic outpatient clinic; 2. To assess change in pain, disability, quality of life and pain catastrophizing at 6, 12 and 26 weeks after the initial evaluation; 3. To assess interprofessional collaboration between the advanced practice physiotherapists and orthopedic surgeons; 4. To assess patient satisfaction with care; 5. To assess waiting time before an initial consultation.

Researchers will compare patients cared in the advanced practice physiotherapy and orthopedic surgeon group and the orthopedic surgeon only group.

Detailed Description

Not available

Study Timeline

• Study First Submitted: 2022-11-07
• Study Start: 2022-11-14
• Study First Submitted QC: 2023-01-26
• Study First Posted: 2023-02-06
• Status Verified: 2023-08
• Last Update Submitted: 2023-08-31
• Last Update Posted: 2023-09-01
• Primary Completion: 2024-01
• Study Completion: 2024-02

Recruitment & Eligibility

• Status: RECRUITING
• Sex: All
• Target Recruitment: 152

Inclusion Criteria

• Adults with peripheral musculoskeletal disorders
• New consultation at the Hôpital Jean-Talon orthopedic outpatient clinic
• Legally able to consent
• Understand and speak French or English
• Beneficiaries of the provincial universal health insurance coverage (RAMQ)

Exclusion Criteria

• Patients directly referred from the emergency department (not considered as patients referred to the outpatient clinic).

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
Advanced practice physiotherapy and orthopedic surgeon group	Advanced practice physiotherapy and orthopedic surgeon management	Patients cared by both an advanced practice physiotherapist and an orthopedic surgeon.
Orthopedic surgeon only group	Orthopedic surgeon management	Patients cared only by an orthopedic surgeon.

Primary Outcome Measures

Name	Time	Method
Brief pain inventory severity	26 weeks (change from baseline)	Pain questionnaire (0-10; higher score=worse)
Brief pain inventory inventory	26 weeks (change from baseline)	Pain interference (disability) questionnaire (0-10; higher score=worse)

Secondary Outcome Measures

Name	Time	Method
Shortened Disability of the Arm, Shoulder and Hand (QuickDASH)	26 weeks (change from baseline)	Disability questionnaire for upper extremity disorders (0-100; higher=worse)
Pain Catastrophizing Scale (PCS)	26 weeks (change from baseline)	Health-related quality of life questionnaire (0-50; higher=worse)
modified validated version of the 9-item visit-specific satisfaction questionnaire (VSQ-9)	0 week (post initial consultation)	Patient satisfaction questionnaire (0-100; higher=better)
Waiting time	Pre-intervention	Waiting time (time in days and minutes)
Hip disability and Osteoarthritis Outcomes Score (HOOS)	26 weeks (change from baseline)	Disability questionnaire for hip disorders (0-100; higher=better)
Knee injury and Osteoarthritis Outcomes Score (KOOS)	26 weeks (change from baseline)	Disability questionnaire for knee disorders (0-100; higher=better)
Foot and Ankle Ability Measure (FAAM)	26 weeks (change from baseline)	Disability questionnaire for ankle/foot disorders (0-100; higher=better)
Modified MedRisk	26 weeks	Patient satisfaction questionnaire (0-100; higher=better)
EQ-5D-5L	26 weeks (change from baseline)	Health-related quality of life questionnaire (to be converted in QALYs 0-1; higher=better)
EQ-5D-VAS	26 weeks (change from baseline)	Health-related quality of life questionnaire (0-100; higher=better)
Patient perceptions of team effectiveness (Patient-PTE)	0 week (post initial consultation)	Perceptions of team effectiveness questionnaire (24-144; higher=better)
Adverse events	26 weeks	Rate of adverse events
Treatment and compliance	26 weeks	Treatment received and % of treatment compliance
Provider perceptions of team effectiveness (Prodiver-PTE)	Through study completion (once)	Perceptions of team effectiveness questionnaire (26-156; higher=better)

Trial Locations

Locations (1)

Centre de recherche de l'Hôpital Maisonneuve-Rosemont; 🇨🇦 Montréal, Quebec, Canada