Advancing Interprofessional Primary Health Care Services in Rural Settings for People With Chronic Low Back Disorders: Investigation of a Physiotherapist and Nurse Practitioner Intervention Delivered Through Telehealth
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 64
- 试验地点
- 2
- 主要终点
- Short term impact of patient/provider satisfaction
研究概览
简要总结
The purpose of this project is to compare "usual care" for chronic low back disorders in a rural setting (nurse practitioner/NP) to two different means of integrating Physical Therapy (PT) into a rural health care team:
- in-person PT assessment, where the PT travels from an urban center
- interprofessional Telehealth assessment where the local NP is joined by a PT via Telehealth.
The project will evaluate health, systems and process outcomes, comparative effectiveness and costs of the three methods of assessment. The hypothesis is that an interprofessional Telehealth assessment with be as effective as an in-person PT assessment, but more effective than usual care.
详细描述
The study design will include two intervention groups and a control group with 20 participants in each group: 1. interprofessional videoconferencing intervention, 2. in-person PT and, 3. "usual-care" provided by a NP. Due to the interprofessional nature of the intervention, the NP involved in the telehealth-based intervention group may alter their "usual care" practice; therefore, the control group participants will be drawn from the practices of 2 NPs not involved in the Telehealth intervention providing services out of a different clinic. Each PT and the NP alone will complete a standardized online diagnostic classification tool.Participants will be randomly assigned to one of the three groups.
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
- Double (Investigator, Outcomes Assessor)
入排标准
- 年龄范围
- 18 Years 至 80 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •adult 18-80
- •low back pain and/or related leg pain affecting function, >3 months duration
排除标准
- •clients within a third party payer insurance coverage system
- •clients with primarily neck or thoracic pain
- •clients with language or comprehension difficulties that would limit completion of paperwork
研究组 & 干预措施
Usual Care (NP)
Rural NP with client in-person, usual care
干预措施: NP face to face management of Chronic Low Back Pain (Other)
PT in-person
Urban PT travels to rural area to manage patient's back pain in-person.
干预措施: PT face to face management of Chronic Low Back Pain (Other)
PT/NP Telehealth
Intervention: Rural NP is joined by PT via Telehealth for interprofessional videoconference with patient
干预措施: Interprofessional Videoconferencing for Chronic Low Back Pain (Other)
结局指标
主要结局
Short term impact of patient/provider satisfaction
时间窗: up to 2 weeks after assessment
questionnaire
Short term outcome of patient experience with Telehealth
时间窗: up to 2 weeks
qualitative questionnaire
Medium term outcome of patient and provider satisfaction
时间窗: 3 months
questionnaire
Short term impact of patient function
时间窗: up to 2 weeks after assessment
Modified Oswestry Disability questionnaire
Short term impact on pain
时间窗: up to 2 weeks after assessment
Numeric Pain Rating Scale - questionnaire
Short term impact on quality of life
时间窗: up to 2 weeks after assessment
Euro-Qol health survey instrument (EQ-5D)
Medium term impact on pain
时间窗: 3 months
Numeric Pain Rating Scale - questionnaire
Medium term impact on quality of life
时间窗: 3 months
Euro-Qol health survey instrument (EQ-5D)
Medium impact on patient function
时间窗: 3 months
Modified Oswestry Disability Index questionnaire
次要结局
- Cost effectiveness of each of 3 arms of study(6 months)
- Long term outcome on patient/provider satisfaction(6 months)
- Long term impact on quality of life(6 months)
- Long term impact on function(6 months)
- Long term impact on pain(6 months)
研究者
Brenna Bath
Assistant Professor, School of Physical Therapy
University of Saskatchewan