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: 1. in-person PT assessment, where the PT travels from an urban center 2. 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.
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.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
64
usual NP management of chronic low back disorder
Includes manual therapy, education, exercise
Includes manual therapy, education, exercise.
University of Saskatchewan
Saskatoon, Saskatchewan, Canada
Short term impact of patient/provider satisfaction
questionnaire
Time frame: up to 2 weeks after assessment
Short term outcome of patient experience with Telehealth
qualitative questionnaire
Time frame: up to 2 weeks
Medium term outcome of patient and provider satisfaction
questionnaire
Time frame: 3 months
Short term impact of patient function
Modified Oswestry Disability questionnaire
Time frame: up to 2 weeks after assessment
Short term impact on pain
Numeric Pain Rating Scale - questionnaire
Time frame: up to 2 weeks after assessment
Short term impact on quality of life
Euro-Qol health survey instrument (EQ-5D)
Time frame: up to 2 weeks after assessment
Medium term impact on pain
Numeric Pain Rating Scale - questionnaire
Time frame: 3 months
Medium term impact on quality of life
Euro-Qol health survey instrument (EQ-5D)
Time frame: 3 months
Medium impact on patient function
Modified Oswestry Disability Index questionnaire
Time frame: 3 months
Cost effectiveness of each of 3 arms of study
patient diaries
Time frame: 6 months
Long term outcome on patient/provider satisfaction
questionnaire
Time frame: 6 months
Long term impact on quality of life
Euro-Qol health survey instrument (EQ-5D)
Time frame: 6 months
Long term impact on function
Modified Oswestry Disability Index questionnaire
Time frame: 6 months
Long term impact on pain
Numeric Pain Rating Scale
Time frame: 6 months
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