Impacts of Physiotherapy Services in a Quebec Emergency Department

NCT04009369 | Completed

• 1 other identifier: MP-20-2019-4307
• Study Type: interventional
• Target: 78
• Locations: 1 country
• Sites: 1

Brief Summary

Emergency departments (ED) in several countries integrated physiotherapists in order to reduce wait times for patients with musculoskeletal disorders (MSKD). These initiatives have indeed reduced wait times, length of stay, time waited before seeing a professional and the prescription of unnecessary consultations and diagnostic tests. In Canada, such initiatives are marginal and their effects have not been studied. The objectives of the project are to evaluate the effects of physiotherapy management of patients with MSKD in ED compared to usual practice on clinical course of patients, use of services and resources, and waiting time and length of stay in ED. The hypothesis is that patients presenting with a MSKD to the ED with direct access to a physiotherapist will have better clinical outcomes and that use of services, waiting time, and length of stay are going to be inferior to those of the EP group.

Conditions

Musculoskeletal Pain; Musculoskeletal Diseases; Musculoskeletal Injury

Keywords

Health care access; Health services; Professional practices

Outcome Measures

Primary Outcomes (2)

• Level of Pain: Numeric Pain Rating Scale

  Scale ranging from 0 to 10 where 0 means no pain at all and 10 means the worst pain ever.

  Baseline, 1 and 3 months

• Pain Interference on Function: Brief Pain Inventory

  List of 10 items (work, sleep, general activity, etc.) represented on a scale ranging from 0 to 10 where 0 means "Does Not Interfere" and 10 means "Completely Interferes". Subscales are averaged and the resulting score is out of 10. A higher score means a higher interference of pain on function.

  Baseline, 1 and 3 months

Secondary Outcomes (7)

• Pain Catastrophizing: Pain Catastrophizing Scale

  Baseline

• Interventions received by the participants : Standardized Form

  Baseline, 1 and 3 months

• Diagnostic Tests : Standardized Form

  Baseline, 1 and 3 months

• Consultations with Another Health Professional : Standardized Form

  Baseline, 1 and 3 months

• Satisfaction: Visit-Specific Satisfaction Instrument

  Baseline

Study Arms (2)

Emergency Physician Group

NO INTERVENTION

Usual care by the EP without the intervention of the ED PT.

Physical Therapist Group

EXPERIMENTAL

Direct access to a PT in the ED immediately after triage and prior to physician assessment.

Other: Direct access to a PT

Interventions

Direct access to a PT OTHER

Direct access to a PT in the ED immediately after triage and prior to physician assessment.

Physical Therapist Group

Eligibility Criteria

• Age: 18 Years - 80 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Triage category 3, 4 or 5
• Discharged home with a minor MSKD after ED care
• Able to consent
• Able to understand French and to complete the questionnaire either verbally or in writing

You may not qualify if:

• Major MSKD requiring urgent care
• Presence of a red flag or an unstable clinical condition
• Living in a long-term care facility

Sponsors & Collaborators

• Rose Gagnon: lead
• CHU de Quebec-Universite Laval: collaborator
• Integrated University Health and Social Services Center of the Capitale-Nationale: collaborator
• Laval University: collaborator

Study Sites (1)

Centre Hospitalier de l'Université Laval (CHUL)

Québec, Quebec, G1V 4G2, Canada

Location

Related Publications (1)

• Gagnon R, Perreault K, Berthelot S, Matifat E, Desmeules F, Achou B, Laroche MC, Van Neste C, Tremblay S, Leblond J, Hebert LJ. Direct-access physiotherapy to help manage patients with musculoskeletal disorders in an emergency department: Results of a randomized controlled trial. Acad Emerg Med. 2021 Aug;28(8):848-858. doi: 10.1111/acem.14237. Epub 2021 Apr 16.

  PMID: 33617696 DERIVED

MeSH Terms

Conditions

Musculoskeletal Pain; Musculoskeletal Diseases

Condition Hierarchy (Ancestors)

Muscular Diseases; Pain; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Study Officials

• Rose Gagnon, MPT, MSc(c)

  Laval University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Master's Student

Study Record Dates

• First Submitted: July 2, 2019
• First Posted: July 5, 2019
• Study Start: September 10, 2018
• Primary Completion: June 27, 2019
• Study Completion: June 27, 2019
• Last Updated: October 28, 2020

Record last verified: 2020-10

Data Sharing

• IPD Sharing: Will not share

Locations

CA (1)