Task-sharing and Shifting Model Between Family Physicians and Physiotherapists for Acute Low Back Pain Patients: a Pragmatic Cluster Randomized Controlled Trial
试验速览
- 阶段
- 不适用
- 发起方
- 入组人数
- 195
- 试验地点
- 6
- 主要终点
- Effect of the TS/S model on acute low back pain (LBP) patients' disability at 6 weeks
研究概览
简要总结
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
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
盲法说明
Data analysis will be blinded.
入排标准
- 年龄范围
- 20 Years 至 55 Years（Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •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)
排除标准
- •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)
研究组 & 干预措施
Task-sharing and shifting
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.
干预措施: Task-sharing and shifting model between family physicians and physiotherapists (Other)
Usual care
In the usual care group, patients with acute low back pain are seen by their family physician.
干预措施: Usual care (Other)
结局指标
主要结局
Effect of the TS/S model on acute low back pain (LBP) patients' disability at 6 weeks
时间窗: 6 weeks after the initial consultation
Rolland Morris Disability Questionnaire It is a 24 points scale. The lower score is 0, the higher score is 24. Higher scores mean worse outcomes as the disability level is higher.
次要结局
- Effect of the TS/S model on acute LBP patient's pain at 6 weeks and 3 months(6 weeks and 3 months after the initial consultation)
- Effect of the TS/S model on acute LBP patient's satisfaction(Few minutes after the initial consultation (less than one hour))
- Effect of the TS/S model on acute LBP patients' disability at 3 months(3 months after the initial consultation)
- Effect of the TS/S model on healthcare resources use(Initial consultation, 6 weeks and 3 months after the initial consultation)
- Effect of the TS/S model on acute LBP patient's psychosocial risk factors at 6 weeks and 3 months(6 weeks and 3 months after the initial consultation)
- Effect of the TS/S model on acute LBP patient's wait time before the initial consultation(Initial consultation)