Consensus for a primary care clinical decision-making tool for assessing, diagnosing, and managing shoulder pain in Alberta, Canada
Abstract Background Shoulder pain is a highly prevalent condition and a significant cause of morbidity and functional disability. Current data suggests that many patients presenting with shoulder pain at the primary care level are not receiving high quality care. Primary care decision-making is comp...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-10-01
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| Series: | BMC Family Practice |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12875-021-01544-3 |
| _version_ | 1811227293597564928 |
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| author | Breda H. F. Eubank Sebastian W. Lackey Mel Slomp Jason R. Werle Colleen Kuntze David M. Sheps |
| author_facet | Breda H. F. Eubank Sebastian W. Lackey Mel Slomp Jason R. Werle Colleen Kuntze David M. Sheps |
| author_sort | Breda H. F. Eubank |
| collection | DOAJ |
| description | Abstract Background Shoulder pain is a highly prevalent condition and a significant cause of morbidity and functional disability. Current data suggests that many patients presenting with shoulder pain at the primary care level are not receiving high quality care. Primary care decision-making is complex and has the potential to influence the quality of care provided and patient outcomes. The aim of this study was to develop a clinical decision-making tool that standardizes care and minimizes uncertainty in assessment, diagnosis, and management. Methods First a rapid review was conducted to identify existing tools and evidence that could support a comprehensive clinical decision-making tool for shoulder pain. Secondly, provincial consensus was established for the assessment, diagnosis, and management of patients presenting to primary care with shoulder pain in Alberta, Canada using a three-step modified Delphi approach. This project was a highly collaborative effort between Alberta Health Services’ Bone and Joint Health Strategic Clinical Network (BJH SCN) and the Alberta Bone and Joint Health Institute (ABJHI). Results A clinical decision-making tool for shoulder pain was developed and reached consensus by a province-wide expert panel representing various health disciplines and geographical regions. This tool consists of a clinical examination algorithm for assessing, diagnosis, and managing shoulder pain; recommendations for history-taking and identification of red flags or additional concerns; recommendations for physical examination and neurological screening; recommendations for the differential diagnosis; and care pathways for managing patients presenting with rotator cuff disease, biceps pathology, superior labral tear, adhesive capsulitis, osteoarthritis, and instability. Conclusions This clinical decision-making tool will help to standardize care, provide guidance on the diagnosis and management of shoulder pain, and assist in clinical decision-making for primary care providers in both public and private sectors. |
| first_indexed | 2024-04-12T09:39:05Z |
| format | Article |
| id | doaj.art-9ceaceaaab024a54a17bd7275a7574c7 |
| institution | Directory Open Access Journal |
| issn | 1471-2296 |
| language | English |
| last_indexed | 2024-04-12T09:39:05Z |
| publishDate | 2021-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Family Practice |
| spelling | doaj.art-9ceaceaaab024a54a17bd7275a7574c72022-12-22T03:38:08ZengBMCBMC Family Practice1471-22962021-10-0122112010.1186/s12875-021-01544-3Consensus for a primary care clinical decision-making tool for assessing, diagnosing, and managing shoulder pain in Alberta, CanadaBreda H. F. Eubank0Sebastian W. Lackey1Mel Slomp2Jason R. Werle3Colleen Kuntze4David M. Sheps5Department of Health & Physical Education, Faculty of Health, Community, & Education, Mount Royal UniversityAlberta Bone and Joint Health InstituteBone and Joint Health Strategic Clinical Network, Alberta Health ServicesBone and Joint Health Strategic Clinical Network, Alberta Health ServicesBone and Joint Health Strategic Clinical Network, Alberta Health ServicesBone and Joint Health Strategic Clinical Network, Alberta Health ServicesAbstract Background Shoulder pain is a highly prevalent condition and a significant cause of morbidity and functional disability. Current data suggests that many patients presenting with shoulder pain at the primary care level are not receiving high quality care. Primary care decision-making is complex and has the potential to influence the quality of care provided and patient outcomes. The aim of this study was to develop a clinical decision-making tool that standardizes care and minimizes uncertainty in assessment, diagnosis, and management. Methods First a rapid review was conducted to identify existing tools and evidence that could support a comprehensive clinical decision-making tool for shoulder pain. Secondly, provincial consensus was established for the assessment, diagnosis, and management of patients presenting to primary care with shoulder pain in Alberta, Canada using a three-step modified Delphi approach. This project was a highly collaborative effort between Alberta Health Services’ Bone and Joint Health Strategic Clinical Network (BJH SCN) and the Alberta Bone and Joint Health Institute (ABJHI). Results A clinical decision-making tool for shoulder pain was developed and reached consensus by a province-wide expert panel representing various health disciplines and geographical regions. This tool consists of a clinical examination algorithm for assessing, diagnosis, and managing shoulder pain; recommendations for history-taking and identification of red flags or additional concerns; recommendations for physical examination and neurological screening; recommendations for the differential diagnosis; and care pathways for managing patients presenting with rotator cuff disease, biceps pathology, superior labral tear, adhesive capsulitis, osteoarthritis, and instability. Conclusions This clinical decision-making tool will help to standardize care, provide guidance on the diagnosis and management of shoulder pain, and assist in clinical decision-making for primary care providers in both public and private sectors.https://doi.org/10.1186/s12875-021-01544-3Shoulder painConsensus methodsDelphi processClinical decision-makingClinical care pathway |
| spellingShingle | Breda H. F. Eubank Sebastian W. Lackey Mel Slomp Jason R. Werle Colleen Kuntze David M. Sheps Consensus for a primary care clinical decision-making tool for assessing, diagnosing, and managing shoulder pain in Alberta, Canada BMC Family Practice Shoulder pain Consensus methods Delphi process Clinical decision-making Clinical care pathway |
| title | Consensus for a primary care clinical decision-making tool for assessing, diagnosing, and managing shoulder pain in Alberta, Canada |
| title_full | Consensus for a primary care clinical decision-making tool for assessing, diagnosing, and managing shoulder pain in Alberta, Canada |
| title_fullStr | Consensus for a primary care clinical decision-making tool for assessing, diagnosing, and managing shoulder pain in Alberta, Canada |
| title_full_unstemmed | Consensus for a primary care clinical decision-making tool for assessing, diagnosing, and managing shoulder pain in Alberta, Canada |
| title_short | Consensus for a primary care clinical decision-making tool for assessing, diagnosing, and managing shoulder pain in Alberta, Canada |
| title_sort | consensus for a primary care clinical decision making tool for assessing diagnosing and managing shoulder pain in alberta canada |
| topic | Shoulder pain Consensus methods Delphi process Clinical decision-making Clinical care pathway |
| url | https://doi.org/10.1186/s12875-021-01544-3 |
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