Physiotherapist Led Triage in Primary Care for Patients With Hip or Knee OA

NCT06187116 | Not Yet Recruiting

• 1 other identifier: PT-triage primary care OA
• Study Type: interventional
• Target: 276
• Locations: 0 countries
• Sites: N/A

Brief Summary

The overall aim with the study is to evaluate physiotherapist led triage in primary care compared to usual care (assessment by an orthopaedic surgeon in an orthopaedic department) for patients with hip or knee osteoarthritis referred for orthopaedic consultation.

Conditions

Osteoarthritis, Knee; Osteoarthritis, Hip

Keywords

Physiotherapist; Orthopaedic triage; Quality of care; Surgery Conversion rate

Outcome Measures

Primary Outcomes (1)

• "I received the best possible examination and treatment (as far as I can tell)"

  One item from the questionnaire Quality from the Patients Perspective (QPP). The patients rate how they perceive the quality of care on a 4-point Likert scale ranging from 1 (do not agree at all) to 4 (completely agree). This item was chosen as main outcome since it was found the be representative of quality of care, and as it assess the desired outcome, by the subjective judgement of experts in the field (five physiotherapists and one orthopaedic surgeon).

  Within a week after assessment

Secondary Outcomes (13)

• Quality from the Patients Perspective (QPP)

  Within a week after assessment

• Waiting times

  12 months after the assessment

• Management outcome incl Surgery Conversion Rate (SCR)

  12 months after the assessment

• EuroQol 5 D (EQ-5D-5L)

  Baseline

• EuroQol 5 D (EQ-5D-5L)

  Change from baseline to three months after assessment

Study Arms (2)

Physiotherapist led orthopaedic triage

EXPERIMENTAL

Patients who are randomised to PT led triage will be scheduled for a consultation with a physiotherapist (PT) at a rehabilitation clinic in primary care in the Region Västra Götaland.

Other: Physiotherapist consultation

Usual care

ACTIVE COMPARATOR

Patients who are randomised to usual care will be sceduled according to standard procedure for an orthopaedic surgeon (OS) consultation at the orthopaedic department of a hospital in the Region Västra Götaland.

Other: Orthopaedic surgeon consultation

Interventions

Physiotherapist consultation OTHER

The consultation with the PT is 40-45 minutes long according to usual care and includes patient history, assessment and management according to an assessment template. If the patient is found not to be appropriate for surgery they can receive the following; 1) self-care without follow up appointment, 2) referral to PT in primary care for rehabilitation, 3) referral back to general practitioner (GP) for new tests/assessments/medication. If the patient is found to be appropriate for surgery, and wishes to undergo surgery, or if the PT in the study wants a second opinion, the patient is 4) referred for orthopaedic consultation for surgical consideration.

Physiotherapist led orthopaedic triage

Orthopaedic surgeon consultation OTHER

The consultation with the OS is 20-30 minutes long and includes medical history, assessment and management plan, all according to usual care. It the patient is found not to be appropriate for surgery they can receive the following; 1) self-care without follow up appointment, 2) referral to PT in primary care for rehabilitation, 3) referral back to GP for new tests/assessments/medication. If the patient is found appropriate for surgery, and wishes to undergo surgery, the patient is 4) scheduled for surgery.

Usual care

Eligibility Criteria

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

You may qualify if:

• primary OA in hip or knee
• understands and speak Swedish

You may not qualify if:

• Previously been assessed for the same condition by an orthopaedic surgeon
• Referred by an orthopaedic surgeon
• Secondary OA due to fractures or osteonecrosis of the femoral head
• Referral to a specific orthopaedic surgeon

Sponsors & Collaborators

• Vastra Gotaland Region: lead

MeSH Terms

Conditions

Osteoarthritis, Knee; Osteoarthritis, Hip

Condition Hierarchy (Ancestors)

Osteoarthritis; Arthritis; Joint Diseases; Musculoskeletal Diseases; Rheumatic Diseases

Central Study Contacts

Karin S Samsson, PhD

CONTACT

+46702526260; karin.samsson@vgregion.se

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: INVESTIGATOR, OUTCOMES ASSESSOR
• Purpose: DIAGNOSTIC
• Intervention Model: PARALLEL
• Sponsor Type: OTHER GOV
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: May 22, 2023
• First Posted: January 2, 2024
• Study Start: January 1, 2024
• Primary Completion: June 1, 2025
• Study Completion (Estimated): June 1, 2027
• Last Updated: January 2, 2024

Record last verified: 2023-12

Data Sharing

• IPD Sharing: Will share
• Time Frame: Data will become available upon reasonable request after publication of results
• Access Criteria: Analyses and additional data will be available upon reasonable request