SupportPrim—a computerized clinical decision support system for stratified care for patients with musculoskeletal pain complaints in general practice: study protocol for a randomized controlled trial
Abstract Background Musculoskeletal disorders represented 149 million years lived with disability world-wide in 2019 and are the main cause of years lived with disability worldwide. Current treatment recommendations are based on “one-size fits all” principle, which does not take into account the lar...
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-04-01
|
| Series: | Trials |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13063-023-07272-6 |
| _version_ | 1797845777490378752 |
|---|---|
| author | Lars Christian Naterstad Lervik Ottar Vasseljen Bjarne Austad Kerstin Bach Anita Formo Bones Fredrik Granviken Jonathan C. Hill Pål Jørgensen Torbjørn Øien Paola Marin Veites Danielle A. Van der Windt Ingebrigt Meisingset |
| author_facet | Lars Christian Naterstad Lervik Ottar Vasseljen Bjarne Austad Kerstin Bach Anita Formo Bones Fredrik Granviken Jonathan C. Hill Pål Jørgensen Torbjørn Øien Paola Marin Veites Danielle A. Van der Windt Ingebrigt Meisingset |
| author_sort | Lars Christian Naterstad Lervik |
| collection | DOAJ |
| description | Abstract Background Musculoskeletal disorders represented 149 million years lived with disability world-wide in 2019 and are the main cause of years lived with disability worldwide. Current treatment recommendations are based on “one-size fits all” principle, which does not take into account the large degree of biopsychosocial heterogeneity in this group of patients. To compensate for this, we developed a stratified care computerized clinical decision support system for general practice based on patient biopsychosocial phenotypes; furthermore, we added personalized treatment recommendations based on specific patient factors to the system. In this study protocol, we describe the randomized controlled trial for evaluating the effectiveness of computerized clinical decision support system for stratified care for patients with common musculoskeletal pain complaints in general practice. The aim of this study is to test the effect of a computerized clinical decision support system for stratified care in general practice on subjective patient outcome variables compared to current care. Methods We will perform a cluster-randomized controlled trial with 44 general practitioners including 748 patients seeking their general practitioner due to pain in the neck, back, shoulder, hip, knee, or multisite. The intervention group will use the computerized clinical decision support system, while the control group will provide current care for their patients. The primary outcomes assessed at 3 months are global perceived effect and clinically important improvement in function measured by the Patient-Specific Function Scale (PSFS), while secondary outcomes include change in pain intensity measured by the Numeric Rating Scale (0–10), health-related quality of life (EQ-5D), general musculoskeletal health (MSK-HQ), number of treatments, use of painkillers, sick-leave grading and duration, referral to secondary care, and use of imaging. Discussion The use of biopsychosocial profile to stratify patients and implement it in a computerized clinical decision support system for general practitioners is a novel method of providing decision support for this patient group. The study aim to recruit patients from May 2022 to March 2023, and the first results from the study will be available late 2023. Trial registration The trial is registered in ISRCTN 11th of May 2022: 14,067,965. |
| first_indexed | 2024-04-09T17:45:30Z |
| format | Article |
| id | doaj.art-e84a21bfa7124390aebbee4df755b66b |
| institution | Directory Open Access Journal |
| issn | 1745-6215 |
| language | English |
| last_indexed | 2024-04-09T17:45:30Z |
| publishDate | 2023-04-01 |
| publisher | BMC |
| record_format | Article |
| series | Trials |
| spelling | doaj.art-e84a21bfa7124390aebbee4df755b66b2023-04-16T11:24:25ZengBMCTrials1745-62152023-04-0124111610.1186/s13063-023-07272-6SupportPrim—a computerized clinical decision support system for stratified care for patients with musculoskeletal pain complaints in general practice: study protocol for a randomized controlled trialLars Christian Naterstad Lervik0Ottar Vasseljen1Bjarne Austad2Kerstin Bach3Anita Formo Bones4Fredrik Granviken5Jonathan C. Hill6Pål Jørgensen7Torbjørn Øien8Paola Marin Veites9Danielle A. Van der Windt10Ingebrigt Meisingset11General Practice Research Unit, Norwegian University of Science and Technology (NTNU)Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU)General Practice Research Unit, Norwegian University of Science and Technology (NTNU)Department of Computer Science, Norwegian University of Science and Technology (NTNU)Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU)Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU)School of Medicine, Primary Care Centre Versus Arthritis, Keele UniversityDepartment of Public Health and Nursing, Norwegian University of Science and Technology (NTNU)General Practice Research Unit, Norwegian University of Science and Technology (NTNU)Department of Computer Science, Norwegian University of Science and Technology (NTNU)School of Medicine, Primary Care Centre Versus Arthritis, Keele UniversityDepartment of Public Health and Nursing, Norwegian University of Science and Technology (NTNU)Abstract Background Musculoskeletal disorders represented 149 million years lived with disability world-wide in 2019 and are the main cause of years lived with disability worldwide. Current treatment recommendations are based on “one-size fits all” principle, which does not take into account the large degree of biopsychosocial heterogeneity in this group of patients. To compensate for this, we developed a stratified care computerized clinical decision support system for general practice based on patient biopsychosocial phenotypes; furthermore, we added personalized treatment recommendations based on specific patient factors to the system. In this study protocol, we describe the randomized controlled trial for evaluating the effectiveness of computerized clinical decision support system for stratified care for patients with common musculoskeletal pain complaints in general practice. The aim of this study is to test the effect of a computerized clinical decision support system for stratified care in general practice on subjective patient outcome variables compared to current care. Methods We will perform a cluster-randomized controlled trial with 44 general practitioners including 748 patients seeking their general practitioner due to pain in the neck, back, shoulder, hip, knee, or multisite. The intervention group will use the computerized clinical decision support system, while the control group will provide current care for their patients. The primary outcomes assessed at 3 months are global perceived effect and clinically important improvement in function measured by the Patient-Specific Function Scale (PSFS), while secondary outcomes include change in pain intensity measured by the Numeric Rating Scale (0–10), health-related quality of life (EQ-5D), general musculoskeletal health (MSK-HQ), number of treatments, use of painkillers, sick-leave grading and duration, referral to secondary care, and use of imaging. Discussion The use of biopsychosocial profile to stratify patients and implement it in a computerized clinical decision support system for general practitioners is a novel method of providing decision support for this patient group. The study aim to recruit patients from May 2022 to March 2023, and the first results from the study will be available late 2023. Trial registration The trial is registered in ISRCTN 11th of May 2022: 14,067,965.https://doi.org/10.1186/s13063-023-07272-6Musculoskeletal disordersGeneral practiceMusculoskeletal painComputerized clinical decision support systemsClinical decision-makingElectronic health records |
| spellingShingle | Lars Christian Naterstad Lervik Ottar Vasseljen Bjarne Austad Kerstin Bach Anita Formo Bones Fredrik Granviken Jonathan C. Hill Pål Jørgensen Torbjørn Øien Paola Marin Veites Danielle A. Van der Windt Ingebrigt Meisingset SupportPrim—a computerized clinical decision support system for stratified care for patients with musculoskeletal pain complaints in general practice: study protocol for a randomized controlled trial Trials Musculoskeletal disorders General practice Musculoskeletal pain Computerized clinical decision support systems Clinical decision-making Electronic health records |
| title | SupportPrim—a computerized clinical decision support system for stratified care for patients with musculoskeletal pain complaints in general practice: study protocol for a randomized controlled trial |
| title_full | SupportPrim—a computerized clinical decision support system for stratified care for patients with musculoskeletal pain complaints in general practice: study protocol for a randomized controlled trial |
| title_fullStr | SupportPrim—a computerized clinical decision support system for stratified care for patients with musculoskeletal pain complaints in general practice: study protocol for a randomized controlled trial |
| title_full_unstemmed | SupportPrim—a computerized clinical decision support system for stratified care for patients with musculoskeletal pain complaints in general practice: study protocol for a randomized controlled trial |
| title_short | SupportPrim—a computerized clinical decision support system for stratified care for patients with musculoskeletal pain complaints in general practice: study protocol for a randomized controlled trial |
| title_sort | supportprim a computerized clinical decision support system for stratified care for patients with musculoskeletal pain complaints in general practice study protocol for a randomized controlled trial |
| topic | Musculoskeletal disorders General practice Musculoskeletal pain Computerized clinical decision support systems Clinical decision-making Electronic health records |
| url | https://doi.org/10.1186/s13063-023-07272-6 |
| work_keys_str_mv | AT larschristiannaterstadlervik supportprimacomputerizedclinicaldecisionsupportsystemforstratifiedcareforpatientswithmusculoskeletalpaincomplaintsingeneralpracticestudyprotocolforarandomizedcontrolledtrial AT ottarvasseljen supportprimacomputerizedclinicaldecisionsupportsystemforstratifiedcareforpatientswithmusculoskeletalpaincomplaintsingeneralpracticestudyprotocolforarandomizedcontrolledtrial AT bjarneaustad supportprimacomputerizedclinicaldecisionsupportsystemforstratifiedcareforpatientswithmusculoskeletalpaincomplaintsingeneralpracticestudyprotocolforarandomizedcontrolledtrial AT kerstinbach supportprimacomputerizedclinicaldecisionsupportsystemforstratifiedcareforpatientswithmusculoskeletalpaincomplaintsingeneralpracticestudyprotocolforarandomizedcontrolledtrial AT anitaformobones supportprimacomputerizedclinicaldecisionsupportsystemforstratifiedcareforpatientswithmusculoskeletalpaincomplaintsingeneralpracticestudyprotocolforarandomizedcontrolledtrial AT fredrikgranviken supportprimacomputerizedclinicaldecisionsupportsystemforstratifiedcareforpatientswithmusculoskeletalpaincomplaintsingeneralpracticestudyprotocolforarandomizedcontrolledtrial AT jonathanchill supportprimacomputerizedclinicaldecisionsupportsystemforstratifiedcareforpatientswithmusculoskeletalpaincomplaintsingeneralpracticestudyprotocolforarandomizedcontrolledtrial AT paljørgensen supportprimacomputerizedclinicaldecisionsupportsystemforstratifiedcareforpatientswithmusculoskeletalpaincomplaintsingeneralpracticestudyprotocolforarandomizedcontrolledtrial AT torbjørnøien supportprimacomputerizedclinicaldecisionsupportsystemforstratifiedcareforpatientswithmusculoskeletalpaincomplaintsingeneralpracticestudyprotocolforarandomizedcontrolledtrial AT paolamarinveites supportprimacomputerizedclinicaldecisionsupportsystemforstratifiedcareforpatientswithmusculoskeletalpaincomplaintsingeneralpracticestudyprotocolforarandomizedcontrolledtrial AT danielleavanderwindt supportprimacomputerizedclinicaldecisionsupportsystemforstratifiedcareforpatientswithmusculoskeletalpaincomplaintsingeneralpracticestudyprotocolforarandomizedcontrolledtrial AT ingebrigtmeisingset supportprimacomputerizedclinicaldecisionsupportsystemforstratifiedcareforpatientswithmusculoskeletalpaincomplaintsingeneralpracticestudyprotocolforarandomizedcontrolledtrial |