Evaluation of Extended Scope Physiotherapists in an Orthopaedic Outpatient Shoulder Clinic

NCT03343951 | Completed

• 1 other identifier: 654821
• Study Type: observational
• Target: 69
• Locations: 1 country
• Sites: 1

Brief Summary

This study investigates the agreement between extended scope physiotherapists (ESP) and orthopaedic surgeons (OS) on diagnosis and treatment plan in an orthopaedic outpatient shoulder clinic. Furthermore a cost analysis and an evaluation of the interdisciplinary collaboration at the orthopaedic outpatient shoulder clinic (termed shoulder clinic in the following) will be performed.

Conditions

Shoulder Injuries and Disorders; Shoulder Pain; Musculoskeletal Pain

Keywords

Physical Therapists; Diagnosis; Clinical Competence; Interprofessional Relations; Cost Analysis

Outcome Measures

Primary Outcomes (3)

• Treatment plan - orthopaedic surgeon

  Treatment plan suggested by the OS will be registered in a chart developed for the occasion. The chart has 5 pre-defined categories: 1) referral to physiotherapy, 2) referral to diagnostic examination, 3) steroid injection, 4) surgery and 5) no intervention (categorical)

  Baseline

• Treatment plan - physiotherapist

  Treatment plan suggested by the ESP will be registered in a chart developed for the occasion. The chart has the same 5 pre-defined categories as for the OS: 1) referral to physiotherapy, 2) referral to diagnostic examination, 3) steroid injection, 4) surgery and 5) no intervention (categorical)

  Baseline

• Treatment plan - common decision

  The OS and ESP will discuss their results until they agree which treatment plan to offer the patient. Their decision will be registered in a chart developed for the occasion. The chart has the same 5 pre-defined categories as for the individual examinations: 1) referral to physiotherapy, 2) referral to diagnostic examination, 3) steroid injection, 4) surgery and 5) no intervention (categorical)

  Baseline

Secondary Outcomes (8)

• Diagnosis - orthopaedic surgeon

  Baseline

• Diagnosis - physiotherapist

  Baseline

• Diagnosis - common decision

  Baseline

• New appointment - orthopaedic surgeon

  Baseline

• New appointment - physiotherapist

  Baseline

Other Outcomes (10)

• Salary - orthopaedic surgeon, first clinical examination

  Baseline

• Salary - orthopaedic surgeon, planned new appointment

  Baseline

• Salary - extended scope physiotherapist, first clinical examination

  Baseline

Study Arms (1)

Shoulder patients

Shoulder patients referred to examination at the shoulder clinic, Silkeborg Regional Hospital.

Other: Examination

Interventions

Examination OTHER

Patients will be examined twice the same day by an extended scope physiotherapist (ESP) and an orthopaedic surgeon (OS) in random order. They will independently and blinded to each other's opinion register * diagnosis and treatment plan (including need for further diagnostic examinations - i.e. imaging) * if the patient needs a new appointment at the shoulder clinic * if they under usual conditions would discuss their results with the opposite health professional before deciding diagnosis and treatment plan. After the individual examinations the ESP and OS discuss their results and come to an agreement (common decision) regarding the patient's diagnosis, treatment plan and need of a new appointment. Patients will be informed only of the common decision of the ESP and OS.

Shoulder patients

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Probability Sample

Study Population

Patients with shoulder problems referred to the shoulder clinic at Silkeborg Regional Hospital.

You may qualify if:

• Above the age of 18 years
• Referred to The Shoulder Clinic at Silkeborg Regional Hospital
• Considered equally appropriate to be examined by an ESP or an OS
• Ability to read and understand Danish

You may not qualify if:

• None

Sponsors & Collaborators

• Central Jutland Regional Hospital: lead

Study Sites (1)

Silkeborg Regional Hospital

Silkeborg, 8600, Denmark

Location

Related Publications (1)

• Madsen MN, Kirkegaard ML, Klebe TM, Linnebjerg CL, Villumsen SMR, Due SJ, Trostrup J, Rossen CB, Birk HO, Elmengaard B, Mikkelsen LR. Inter-professional agreement and collaboration between extended scope physiotherapists and orthopaedic surgeons in an orthopaedic outpatient shoulder clinic - a mixed methods study. BMC Musculoskelet Disord. 2021 Jan 4;22(1):4. doi: 10.1186/s12891-020-03831-z.

  PMID: 33397350 DERIVED

MeSH Terms

Conditions

Shoulder Injuries; Disease; Shoulder Pain; Musculoskeletal Pain

Interventions

Restraint, Physical

Condition Hierarchy (Ancestors)

Wounds and Injuries; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Arthralgia; Joint Diseases; Musculoskeletal Diseases; Pain; Neurologic Manifestations; Signs and Symptoms; Muscular Diseases

Intervention Hierarchy (Ancestors)

Behavior Control; Therapeutics; Immobilization; Investigative Techniques

Study Officials

• Merete N Madsen, MSc

  Silkeborg Regional Hospital

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: CROSS SECTIONAL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: November 10, 2017
• First Posted: November 17, 2017
• Study Start: November 17, 2017
• Primary Completion: April 13, 2018
• Study Completion: June 19, 2018
• Last Updated: August 15, 2018

Record last verified: 2018-02

Data Sharing

• IPD Sharing: Will not share

Locations

DK (1)