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
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
195
Medical consultations for acute low back pain patients are shifted from family physicians to physiotherapists.
Medical consultations for acute low back pain patients are performed by family physicians
Maison de santé pluriprofessionnelle de Cran Gévrier
Annecy, Auvergne-Rhône-Alpes, France
RECRUITINGMaison de santé pluriprofessionnelle des Hauts de Chambéry
Chambéry, Auvergne-Rhône-Alpes, France
RECRUITINGMaison de santé pluriprofessionnelle de Voiron-Sud
Effect of the TS/S model on acute low back pain (LBP) patients' disability at 6 weeks
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.
Time frame: 6 weeks after the initial consultation
Effect of the TS/S model on acute LBP patients' disability at 3 months
Rolland Morris Disability Questionnaire It is a 24 points scale. Scores rank form 0 to 24. Higher scores mean worse outcomes as the disability level is higher.
Time frame: 3 months after the initial consultation
Effect of the TS/S model on acute LBP patient's pain at 6 weeks and 3 months
Brief Pain Inventory It is a 10 points scale. Scores rank from 0 to 10. Higher scores mean worse outcomes, as the pain level is higher.
Time frame: 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
Start-Back screening tool It is a 9 points scale. Scores rank from 0 to 9. Higher scores mean worse outcomes.
Time frame: 6 weeks and 3 months after the initial consultation
Effect of the TS/S model on acute LBP patient's satisfaction
Medrisk questionnaire It is a 5 points scale. Scores rank from 0 to 5. Higher scores mean better outcomes;
Time frame: Few minutes after the initial consultation (less than one hour)
Effect of the TS/S model on acute LBP patient's wait time before the initial consultation
Time (number of days and hours)
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Coublevie, Auvergne-Rhône-Alpes, France
Maison de santé pluriprofessionnelle de Lans-en-Vercors - Pôle Santé en Vercors
Lans-en-Vercors, Auvergne-Rhône-Alpes, France
RECRUITINGMaison de santé pluriprofessionnelle de Moirans
Moirans, Auvergne-Rhône-Alpes, France
RECRUITINGPôle de santé interprofessionnel de Saint-Martin d'Hères
Saint-Martin-d'Hères, Auvergne-Rhône-Alpes, France
RECRUITINGTime frame: Initial consultation
Effect of the TS/S model on healthcare resources use
Initial prescription of sick leave and medications, number of family physician visits, number of physical therapy appointments, number of emergency department visits at 6 weeks and 3 months
Time frame: Initial consultation, 6 weeks and 3 months after the initial consultation