Assessing the feasibility of a clinical trial to evaluate an advanced practice physiotherapy model of care in chronic pain management: a feasibility study
Abstract Background Chronic pain management is challenging for health systems worldwide. Clinical practice guidelines recommend interprofessional chronic pain management, but chronic pain clinics often have lengthy wait-lists. Advanced practice physiotherapists (APP) in orthopedic clinics and emerge...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-07-01
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| Series: | Pilot and Feasibility Studies |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40814-023-01352-9 |
| _version_ | 1797774362728726528 |
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| author | Jordan Miller Tom Doulas Etienne J. Bisson Abey Abebe Mulugeta Chala Chad McClintock Kevin Varette Kyle Vader François Desmeules Kadija Perreault Catherine Donnelly Randy Booth Andrews K. Tawiah Scott Duggan |
| author_facet | Jordan Miller Tom Doulas Etienne J. Bisson Abey Abebe Mulugeta Chala Chad McClintock Kevin Varette Kyle Vader François Desmeules Kadija Perreault Catherine Donnelly Randy Booth Andrews K. Tawiah Scott Duggan |
| author_sort | Jordan Miller |
| collection | DOAJ |
| description | Abstract Background Chronic pain management is challenging for health systems worldwide. Clinical practice guidelines recommend interprofessional chronic pain management, but chronic pain clinics often have lengthy wait-lists. Advanced practice physiotherapists (APP) in orthopedic clinics and emergency departments have provided effective care and reduced wait times. The purpose of this study is to determine the feasibility of a clinical trial to evaluate the effects of integrating an APP into a chronic pain clinic setting. The primary objectives are as follows: (1) determine the feasibility of implementing trial methods by evaluating participant recruitment rates, retention, and assessment completion; (2) determine the feasibility of implementing the APP model of care by monitoring care provided and treatment fidelity; and (3) assess contextual factors that may influence implementation of the APP model of care by exploring the perspectives of patient participants and healthcare providers related to the model of care. Methods This will be a single-arm feasibility study with embedded qualitative interviews to assess contextual factors influencing implementation by exploring participant and provider perspectives. Approximately 40 adults with chronic musculoskeletal pain referred for care at an interprofessional chronic pain clinic will be invited to participate in the feasibility study. Approximately 10–12 patient participants and 5–10 health professionals from the interprofessional team will be interviewed using an interpretive description approach. The APP model of care will involve participants seeing a physiotherapist as the first point of contact within the interprofessional team. The APP will complete an initial assessment and make care recommendations. Outcome measures planned for the full trial will be reported descriptively, including pain severity, pain interference, health-related quality of life, psychosocial risk factors for chronic pain, treatment satisfaction, perceived change, healthcare utilization, and healthcare costs over one year. Discussion This study will inform plans to implement a full-scale study to evaluate the impact of an APP model of care in an interprofessional chronic pain management program. The results of the full study are intended to inform stakeholders considering this model to improve patient-centered and health system outcomes in interprofessional pain management program settings. Trial registration ClinicalTrials.gov, NCT05336903 (Registered April 5, 2022). |
| first_indexed | 2024-03-12T22:19:55Z |
| format | Article |
| id | doaj.art-8f7ed13578174acd8e7213d70d4a10cc |
| institution | Directory Open Access Journal |
| issn | 2055-5784 |
| language | English |
| last_indexed | 2024-03-12T22:19:55Z |
| publishDate | 2023-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Pilot and Feasibility Studies |
| spelling | doaj.art-8f7ed13578174acd8e7213d70d4a10cc2023-07-23T11:07:14ZengBMCPilot and Feasibility Studies2055-57842023-07-019111110.1186/s40814-023-01352-9Assessing the feasibility of a clinical trial to evaluate an advanced practice physiotherapy model of care in chronic pain management: a feasibility studyJordan Miller0Tom Doulas1Etienne J. Bisson2Abey Abebe3Mulugeta Chala4Chad McClintock5Kevin Varette6Kyle Vader7François Desmeules8Kadija Perreault9Catherine Donnelly10Randy Booth11Andrews K. Tawiah12Scott Duggan13School of Rehabilitation Therapy, Queen’s UniversityChronic Pain Clinic, Kingston Health Sciences Centre — Hotel Dieu Hospital siteChronic Pain Clinic, Kingston Health Sciences Centre — Hotel Dieu Hospital siteSchool of Rehabilitation Therapy, Queen’s UniversitySchool of Rehabilitation Therapy, Queen’s UniversitySchool of Rehabilitation Therapy, Queen’s UniversitySchool of Rehabilitation Therapy, Queen’s UniversitySchool of Rehabilitation Therapy, Queen’s UniversitySchool of Rehabilitation, Université de MontréalCentre Interdisciplinaire de Recherche en Réadaptation Et Intégration Sociale, Centre de Santé Et de Services Sociaux de La Capitale-NationaleSchool of Rehabilitation Therapy, Queen’s UniversitySchool of Rehabilitation Therapy, Queen’s UniversityFaculty of Rehabilitation Medicine, University of AlbertaChronic Pain Clinic, Kingston Health Sciences Centre — Hotel Dieu Hospital siteAbstract Background Chronic pain management is challenging for health systems worldwide. Clinical practice guidelines recommend interprofessional chronic pain management, but chronic pain clinics often have lengthy wait-lists. Advanced practice physiotherapists (APP) in orthopedic clinics and emergency departments have provided effective care and reduced wait times. The purpose of this study is to determine the feasibility of a clinical trial to evaluate the effects of integrating an APP into a chronic pain clinic setting. The primary objectives are as follows: (1) determine the feasibility of implementing trial methods by evaluating participant recruitment rates, retention, and assessment completion; (2) determine the feasibility of implementing the APP model of care by monitoring care provided and treatment fidelity; and (3) assess contextual factors that may influence implementation of the APP model of care by exploring the perspectives of patient participants and healthcare providers related to the model of care. Methods This will be a single-arm feasibility study with embedded qualitative interviews to assess contextual factors influencing implementation by exploring participant and provider perspectives. Approximately 40 adults with chronic musculoskeletal pain referred for care at an interprofessional chronic pain clinic will be invited to participate in the feasibility study. Approximately 10–12 patient participants and 5–10 health professionals from the interprofessional team will be interviewed using an interpretive description approach. The APP model of care will involve participants seeing a physiotherapist as the first point of contact within the interprofessional team. The APP will complete an initial assessment and make care recommendations. Outcome measures planned for the full trial will be reported descriptively, including pain severity, pain interference, health-related quality of life, psychosocial risk factors for chronic pain, treatment satisfaction, perceived change, healthcare utilization, and healthcare costs over one year. Discussion This study will inform plans to implement a full-scale study to evaluate the impact of an APP model of care in an interprofessional chronic pain management program. The results of the full study are intended to inform stakeholders considering this model to improve patient-centered and health system outcomes in interprofessional pain management program settings. Trial registration ClinicalTrials.gov, NCT05336903 (Registered April 5, 2022).https://doi.org/10.1186/s40814-023-01352-9Chronic painAdvanced practice physiotherapyFeasibility studyInterprofessional |
| spellingShingle | Jordan Miller Tom Doulas Etienne J. Bisson Abey Abebe Mulugeta Chala Chad McClintock Kevin Varette Kyle Vader François Desmeules Kadija Perreault Catherine Donnelly Randy Booth Andrews K. Tawiah Scott Duggan Assessing the feasibility of a clinical trial to evaluate an advanced practice physiotherapy model of care in chronic pain management: a feasibility study Pilot and Feasibility Studies Chronic pain Advanced practice physiotherapy Feasibility study Interprofessional |
| title | Assessing the feasibility of a clinical trial to evaluate an advanced practice physiotherapy model of care in chronic pain management: a feasibility study |
| title_full | Assessing the feasibility of a clinical trial to evaluate an advanced practice physiotherapy model of care in chronic pain management: a feasibility study |
| title_fullStr | Assessing the feasibility of a clinical trial to evaluate an advanced practice physiotherapy model of care in chronic pain management: a feasibility study |
| title_full_unstemmed | Assessing the feasibility of a clinical trial to evaluate an advanced practice physiotherapy model of care in chronic pain management: a feasibility study |
| title_short | Assessing the feasibility of a clinical trial to evaluate an advanced practice physiotherapy model of care in chronic pain management: a feasibility study |
| title_sort | assessing the feasibility of a clinical trial to evaluate an advanced practice physiotherapy model of care in chronic pain management a feasibility study |
| topic | Chronic pain Advanced practice physiotherapy Feasibility study Interprofessional |
| url | https://doi.org/10.1186/s40814-023-01352-9 |
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