Models of Care for Musculoskeletal Disorders
(Edu1st Trial)
Trial Summary
Will I have to stop taking my current medications?
The trial protocol does not specify whether you need to stop taking your current medications. However, if you have received a corticosteroid injection in the past 3 months or have had an intervention for your condition in the last 6 weeks, you may not be eligible to participate.
What data supports the effectiveness of the treatment for musculoskeletal disorders?
Research shows that structured models of care, like stepped care for osteoarthritis and risk-stratified care for low back pain, can help improve treatment outcomes by tailoring interventions based on patient needs. These models share common features and may be combined to enhance care for musculoskeletal conditions.12345
Is the treatment for musculoskeletal disorders generally safe for humans?
How does the Stepped Care treatment for musculoskeletal disorders differ from other treatments?
Stepped Care is unique because it adjusts the level of treatment based on how well a patient responds, starting with simpler interventions and only moving to more comprehensive care if needed. This approach is different from other treatments that might not tailor the intensity of care to individual patient responses.16111213
What is the purpose of this trial?
As musculoskeletal disorders (MSKDs) reach epidemic proportions in Canada, access to the public health system for those who suffer from them is increasingly difficult. One of the main barriers is the delays to see a publicly funded health professional. New models of care must therefore be developed to ensure better access. We have previously shown that not all patients with a MSKD need to be closely followed by a health professional as for a large proportion of patients simply educating them is enough to resolve their MSKD. A stepped care model where education would be given first before deciding if patients need a more extensive follow-up should be explored. This project will compare the effectiveness of a Stepped Care Model to that of the two most widely used models of care: Usual Medical Care and Usual Rehabilitation Care. We think that a Stepped Care Model will be as effective to reduce functional limitations, but will lead to lower healthcare costs.Adults (n=369) with a MSKD will be randomly assigned to one of the intervention groups: Stepped Care, Usual Medical Care (physician-led intervention: e.g., advice/education, pharmacological pain management), or Usual Rehabilitation Care (physiotherapist-led intervention: e.g., advice/education, exercises). Participants in the Stepped Care Group will take part in two education sessions during the first 6 weeks. After 6 weeks, those who still have clinically important symptoms will receive follow-up rehabilitation interventions, while those who don't will be considered recovered and will have no further intervention. Primary (functional limitations) and secondary (e.g., pain, quality of life) outcomes will be assessed at baseline, and at 6, 12 and 24 weeks, and costs estimate will be established for each model of care. Knowing the urgent need for an overhaul of services to reduce wait times, the Stepped Care Model proposed could be a solution to improve access to health services without compromising quality of care.
Research Team
Jean-Sebastien Roy, PT, PhD
Principal Investigator
Laval University
Eligibility Criteria
This trial is for adults with musculoskeletal disorders such as low back pain, neck pain, shoulder issues, and patellofemoral syndrome. It's designed to test different care models in Canada due to long wait times for treatment. Participants will be randomly assigned to one of three groups: Stepped Care, Usual Medical Care, or Usual Rehabilitation Care.Inclusion Criteria
Exclusion Criteria
Timeline
Screening
Participants are screened for eligibility to participate in the trial
Initial Treatment
Participants in the Stepped Care Group receive two education sessions over 6 weeks. Usual Medical Care involves up to 3 physician appointments, and Usual Rehabilitation Care involves up to 10 physiotherapist appointments over 12 weeks.
Follow-up Treatment
Participants in the Stepped Care Group with unresolved symptoms receive up to 5 additional physiotherapy sessions over 6 weeks.
Follow-up
Participants are monitored for safety and effectiveness after treatment, with assessments at 6, 12, and 24 weeks.
Treatment Details
Interventions
- Medical Care
- Rehabilitation Care
- Stepped Care
Find a Clinic Near You
Who Is Running the Clinical Trial?
Laval University
Lead Sponsor