Effect and Cost of a Physiotherapy-led Care Model in Emergency Departments for Patients With Minor Musculoskeletal Injuries

NCT07137754 | Recruiting

• 2 other identifiers: Journal no. 1-10-72-137-244285-00270B
• Study Type: interventional
• Target: 800
• Locations: 1 country
• Sites: 1

Brief Summary

Both in Denmark and internationally, emergency departments have been overwhelmed for several years by a growing number of patients, combined with a shortage of doctors and nurses. This problem is expected to continue because the number of elderly people with multiple health problems is increasing. To keep providing good quality care in emergency departments, we need to consider new ways of organizing treatment. In Canada, Australia, and the UK, some hospitals have tried a model where specially trained physiotherapists examine and treat patients who come in with muscle and joint injuries and pain. Since these patients make up about 25% of all those referred to emergency departments, this model could help take some pressure off doctors and nurses. That way, doctors and nurses can spend more time caring for seriously ill patients who need urgent help. Several studies on these physiotherapist-led models show benefits for both patients and the healthcare system. Patients report being more satisfied and better informed about their injury and treatment. They wait less, have fewer unnecessary tests, and need fewer repeat visits to the emergency department. However, similar studies have never been done in Scandinavia, even though some Danish emergency departments have tested similar models. Healthcare systems and the education of physiotherapists differ between Scandinavian countries and the countries mentioned above. So, we don't know if we would see the same benefits here. Also, there has been no research on whether this model is cost-effective, which is important for decision-makers when planning future healthcare budgets. With this research project, we want to test a model in Danish hospitals where specially trained physiotherapists take care of examining, treating, and discharging patients with muscle and joint pain and injuries. We will look at how this model affects patient experiences (like pain and satisfaction) and clinical outcomes (like repeat emergency visits and use of imaging tests), compared to the usual practice where doctors handle these patients. We will also study whether the model is cost-effective, meaning whether the benefits of using this approach are worth the costs, or even greater than the costs. The study will be conducted at 4-5 hospitals, where a total of 800 patients with minor musculoskeletal injuries will be included in connection with their visit at the emergency department. Patients will receive questionnaires at 1, 4, 12 and 26 weeks after injury regarding patient reported outcomes. Register data will be retrieved at 26 weeks regarding the patients' health care use during follow-up.

Conditions

Musculoskeletal Disorders; Emergency Care; Physiotherapy

Outcome Measures

Primary Outcomes (2)

• Brief pain inventory short form

  BPI short form is a self-reported questionnaire, using the 7 items pain interference on functional ability, mood, sleep and work. The patient completes the assessment at baseline, 1, 4, 12 and 26 weeks after injury

  From baseline (time of injury) to 12 weeks follow-up

• Euroqol 5 Dimensions 5 Levels

  The EQ5D assesses health-related quality of life using 5 items. It is used as the primary outcome for qualculation of QUALYs in the health economic analysis.

  From baseline to 26 weeks

Secondary Outcomes (6)

• Visit-specific satisfaction questionnaire

  Is collected at week 1 after baseline

• PROMIS short form physical function

  From baseline to 12 weeks after.

• PROMIS short form upper extremety

  From baseline to 12 weeks

• Work Productivity and Activity Impairment

  From baseline to 12 weeks

• Return-visits to emergency department

  From baseline to 12 week follow-up

Study Arms (2)

Advanced practice physiotherapy

EXPERIMENTAL

Advanced practice physiotherapists will independently diagnose, manage and discharge patients

Other: Advanced practice physiotherapy

Usual care

ACTIVE COMPARATOR

Nurses and physicians in the emergency department will diagnose, manage and discharge patients as per usual care

Other: Usual Care

Interventions

Advanced practice physiotherapy OTHER

Physiotherapists undergoing post-graduate education as advanced practice physiotherapists will independently diagnose, manage and discharge patients.

Advanced practice physiotherapy

Usual Care OTHER

Nurses and physicians in the emergency department will diagnose, manage and discharge patients as usual

Usual care

Eligibility Criteria

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

You may qualify if:

• Musculoskeletal pain and injury to the upper or lower extremities
• Triaged non-urgent (blue) in the emergency department
• Speaks and understands Danish

You may not qualify if:

• High velocity trauma
• Cognitively unable to participate
• Non-malignant conditions (cancer, inflammation, infection)

Sponsors & Collaborators

• Aarhus University Hospital: lead
• Slagelse Hospital: collaborator
• Gødstrup Hospital: collaborator
• Université de Montréal: collaborator
• Independent Research Fund Denmark: collaborator
• University of Aarhus: collaborator
• Danske Fysioterapeuter: collaborator

Study Sites (1)

Aarhus University Hospital

Aarhus N, 8200, Denmark

RECRUITING

MeSH Terms

Conditions

Musculoskeletal Diseases

Study Officials

• Nanna Rolving, Associate professor

  Aarhus University Hospital

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Nanna Rolving, Associate professor

CONTACT

+45 40321618; Nanna.Rolving@rm.dk

Louise Mortensen, PhD student

CONTACT

louimr@rm.dk

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate professor

Study Record Dates

• First Submitted: August 15, 2025
• First Posted: August 22, 2025
• Study Start: August 15, 2025
• Primary Completion (Estimated): March 1, 2028
• Study Completion (Estimated): March 1, 2028
• Last Updated: August 28, 2025

Record last verified: 2025-08

Locations

DK (1)