SupportPrim—a computerized clinical decision support system for stratified care for patients with musculoskeletal pain complaints in general practice: study protocol for a randomized controlled trial
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Abstract
Background: Musculoskeletal disorders represented 149 million years lived with disability world-wide in 2019 and are the main cause of years lived with disability worldwide. Current treatment recommendations are based on “one-size fits all” principle, which does not take into account the large degree of biopsychosocial heterogeneity in this group of patients. To compensate for this, we developed a stratified care computerized clinical decision support system for general practice based on patient biopsychosocial phenotypes; furthermore, we added personalized treatment recommendations based on specific patient factors to the system. In this study protocol, we describe the randomized controlled trial for evaluating the effectiveness of computerized clinical decision support system for stratified care for patients with common musculoskeletal pain complaints in general practice. The aim of this study is to test the effect of a computerized clinical decision support system for stratified care in general practice on subjective patient outcome variables compared to current care. Methods: We will perform a cluster-randomized controlled trial with 44 general practitioners including 748 patients seeking their general practitioner due to pain in the neck, back, shoulder, hip, knee, or multisite. The intervention group will use the computerized clinical decision support system, while the control group will provide current care for their patients. The primary outcomes assessed at 3 months are global perceived effect and clinically important improvement in function measured by the Patient-Specific Function Scale (PSFS), while secondary outcomes include change in pain intensity measured by the Numeric Rating Scale (0–10), health-related quality of life (EQ-5D), general musculoskeletal health (MSK-HQ), number of treatments, use of painkillers, sick-leave grading and duration, referral to secondary care, and use of imaging. Discussion: The use of biopsychosocial profile to stratify patients and implement it in a computerized clinical decision support system for general practitioners is a novel method of providing decision support for this patient group. The study aim to recruit patients from May 2022 to March 2023, and the first results from the study will be available late 2023. Trial registration: The trial is registered in ISRCTN 11th of May 2022: 14,067,965.
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Cites
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BackgroundSelf-citationGP crisis requires more than just technology to fix it
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SPIRIT 2025 explanation and elaboration: updated guideline for protocols of randomised trials
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“Previous MSK CDSS trials, including SupportPrim [14] and STarT MSK [15], did not assess care quality directly and showed limited influence on clinician decision-making.”
Self-citation
- Authors
- Lervik, L. C. N., Vasseljen, O., Austad, B., Bach, K., Bones, A. F., Granviken, F., Hill, J. C., Jørgensen, P., Øien, T., Veites, P. M., Van der Windt, D. A., & Meisingset, I.
- Affiliations
- Norwegian University of Science and Technology (NO)
- Arthritis UK (GB)
- Corresponding author
- Lervik, Lars Christian Naterstad
- ORCID
- Venue
- Trials
- Published
- 2023-04-11
- Volume
- 24
- Issue
- 1
- Pages
- 267-267
- ISSN
- 1745-6215 (ISSN-L)
- PMC
- PMC10088189
- OpenAlex
- W4364359195
- Cited by
- 12
- References
- 48
- Citations by year
- 2026: 1 · 2025: 5 · 2024: 5 · 2023: 1
- FWCI
- 1.85
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Trials (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Keele Research Repository (Keele University) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Norges Forskningsråd (ref 303331)
- NTNU Norwegian University of Science and Technology
- Topics
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
- Health Sciences › Medicine › Rehabilitation › Musculoskeletal Disorders and Rehabilitation
- Keywords
- computerized clinical decision support systems, stratified care, musculoskeletal pain, general practice, personalized treatment recommendations, neck and back pain, shoulder pain, health-related quality of life, sick leave, secondary care referral, analgesics
- MeSH terms
- Humans, Quality of Life, Randomized Controlled Trials as Topic, Decision Support Systems, Clinical, General Practitioners, General Practice, Musculoskeletal Pain
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