Task-sharing and Shifting Model for Acute Low Back Pain

NCT ID: NCT05200533

Last Updated: 2023-06-27

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

195 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-03-01

Study Completion Date

2024-01-31

Brief Summary

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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

Detailed Description

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Conditions

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Low Back Pain

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Cluster randomized controlled trial
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Data analysis will be blinded.

Study Groups

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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.

Group Type EXPERIMENTAL

Task-sharing and shifting model between family physicians and physiotherapists

Intervention Type OTHER

Medical consultations for acute low back pain patients are shifted from family physicians to physiotherapists.

Usual care

In the usual care group, patients with acute low back pain are seen by their family physician.

Group Type ACTIVE_COMPARATOR

Usual care

Intervention Type OTHER

Medical consultations for acute low back pain patients are performed by family physicians

Interventions

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Task-sharing and shifting model between family physicians and physiotherapists

Medical consultations for acute low back pain patients are shifted from family physicians to physiotherapists.

Intervention Type OTHER

Usual care

Medical consultations for acute low back pain patients are performed by family physicians

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* 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)

Exclusion Criteria

* 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)
Minimum Eligible Age

20 Years

Maximum Eligible Age

55 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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TIMC-IMAG

OTHER

Sponsor Role collaborator

University Hospital, Grenoble

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Nicolas Pinsault, PhD

Role: STUDY_DIRECTOR

University Grenoble Alps

Locations

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Maison de santé pluriprofessionnelle de Cran Gévrier

Annecy, Auvergne-Rhône-Alpes, France

Site Status RECRUITING

Maison de santé pluriprofessionnelle des Hauts de Chambéry

Chambéry, Auvergne-Rhône-Alpes, France

Site Status RECRUITING

Maison de santé pluriprofessionnelle de Voiron-Sud

Coublevie, Auvergne-Rhône-Alpes, France

Site Status RECRUITING

Maison de santé pluriprofessionnelle de Lans-en-Vercors - Pôle Santé en Vercors

Lans-en-Vercors, Auvergne-Rhône-Alpes, France

Site Status RECRUITING

Maison de santé pluriprofessionnelle de Moirans

Moirans, Auvergne-Rhône-Alpes, France

Site Status RECRUITING

Pôle de santé interprofessionnel de Saint-Martin d'Hères

Saint-Martin-d'Hères, Auvergne-Rhône-Alpes, France

Site Status RECRUITING

Countries

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France

Central Contacts

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Amelie Kechichian, PhD student

Role: CONTACT

+33 (0)698304997

Aida Mandzo

Role: CONTACT

+33(0)476766816

Facility Contacts

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Céline Tuttino

Role: primary

Emilie Fuentes

Role: primary

Sabine Pages

Role: primary

Laetitia Wrona

Role: primary

Sabine Pages

Role: primary

Maxime Bertolini

Role: primary

References

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Babatunde OO, Bishop A, Cottrell E, Jordan JL, Corp N, Humphries K, Hadley-Barrows T, Huntley AL, van der Windt DA. A systematic review and evidence synthesis of non-medical triage, self-referral and direct access services for patients with musculoskeletal pain. PLoS One. 2020 Jul 6;15(7):e0235364. doi: 10.1371/journal.pone.0235364. eCollection 2020.

Reference Type BACKGROUND
PMID: 32628696 (View on PubMed)

Demont A, Bourmaud A, Kechichian A, Desmeules F. The impact of direct access physiotherapy compared to primary care physician led usual care for patients with musculoskeletal disorders: a systematic review of the literature. Disabil Rehabil. 2021 Jun;43(12):1637-1648. doi: 10.1080/09638288.2019.1674388. Epub 2019 Oct 11.

Reference Type BACKGROUND
PMID: 31603709 (View on PubMed)

Chiarotto A, Maxwell LJ, Terwee CB, Wells GA, Tugwell P, Ostelo RW. Roland-Morris Disability Questionnaire and Oswestry Disability Index: Which Has Better Measurement Properties for Measuring Physical Functioning in Nonspecific Low Back Pain? Systematic Review and Meta-Analysis. Phys Ther. 2016 Oct;96(10):1620-1637. doi: 10.2522/ptj.20150420. Epub 2016 Apr 14.

Reference Type BACKGROUND
PMID: 27081203 (View on PubMed)

Desmeules F, Roy JS, MacDermid JC, Champagne F, Hinse O, Woodhouse LJ. Advanced practice physiotherapy in patients with musculoskeletal disorders: a systematic review. BMC Musculoskelet Disord. 2012 Jun 21;13:107. doi: 10.1186/1471-2474-13-107.

Reference Type BACKGROUND
PMID: 22716771 (View on PubMed)

Hill JC, Whitehurst DG, Lewis M, Bryan S, Dunn KM, Foster NE, Konstantinou K, Main CJ, Mason E, Somerville S, Sowden G, Vohora K, Hay EM. Comparison of stratified primary care management for low back pain with current best practice (STarT Back): a randomised controlled trial. Lancet. 2011 Oct 29;378(9802):1560-71. doi: 10.1016/S0140-6736(11)60937-9. Epub 2011 Sep 28.

Reference Type BACKGROUND
PMID: 21963002 (View on PubMed)

Kechichian A, Lafrance S, Matifat E, Dube F, Lussier D, Benhaim P, Perreault K, Filiatrault J, Rainville P, Higgins J, Rousseau J, Masse J, Desmeules F. Multimodal Interventions Including Rehabilitation Exercise for Older Adults With Chronic Musculoskeletal Pain: A Systematic Review and Meta-analyses of Randomized Controlled Trials. J Geriatr Phys Ther. 2022 Jan-Mar 01;45(1):34-49. doi: 10.1519/JPT.0000000000000279.

Reference Type BACKGROUND
PMID: 34928239 (View on PubMed)

Kechichian A, Desmeules F, Girard P, Terrisse H, Vermorel C, Pinsault N. Physiotherapists as first-contact practitioners for patients with low back pain in French primary care: a pragmatic cluster randomised controlled trial. BMC Health Serv Res. 2024 Nov 18;24(1):1427. doi: 10.1186/s12913-024-11814-2.

Reference Type DERIVED
PMID: 39558330 (View on PubMed)

Other Identifiers

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38RC21.0259

Identifier Type: -

Identifier Source: org_study_id

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