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PreprintCited by 2Musculoskeletal pain and rehabilitationElectronic Health Records SystemsMusculoskeletal Disorders and Rehabilitation

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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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Lervik, Lars Christian Naterstad, Vasseljen, Ottar, Austad, Bjarne, Bach, Kerstin, Bones, Anita Formo, Granviken, Fredrik, Hill, Jonathan C., Jørgensen, Pål, Øien, Torbjørn, Veites, Paola Marin, Windt, Danielle A. Van der, Meisingset, Ingebrigt·2023·Research Square
DOI 10.21203/rs.3.rs-2608193/v1

Preprint — published as 10.1186/s13063-023-07272-6 · Paper page

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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, further, 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: 14067965

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  1. Cieza A, Causey K, Kamenov K, Hanson SW, Chatterji S, Vos T. Global estimates of the need for rehabilitation based on the Global Burden of Disease study 2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2021;396(10267):2006–17. · DOI
  2. Hartvigsen J, Hancock MJ, Kongsted A, Louw Q, Ferreira ML, Genevay S, et al. What low back pain is and why we need to pay attention. Lancet. 2018;391(10137):2356–67. · DOI · Paper page
  3. Kinge JM, Knudsen AK, Skirbekk V, Vollset SE. Musculoskeletal disorders in Norway: prevalence of chronicity and use of primary and specialist health care services. BMC Musculoskelet Disord. 2015;16:75. · DOI
  4. Laerum E, Brage S, Ihlebaek C, Johnsen K, Natvig B, Aas E. Et muskel- og skjelettregnskap. Forekomst og kostnader knyttet til skader, sykdommer og plager i muskel- og skjelettystemet. FORMI; 2013.
  5. de Vos Andersen NB, Kent P, Hjort J, Christiansen DH. Clinical course and prognosis of musculoskeletal pain in patients referred for physiotherapy: does pain site matter? BMC Musculoskelet Disord. 2017;18(1):130. · DOI
  6. Briggs AM, Cross MJ, Hoy DG, Sanchez-Riera L, Blyth FM, Woolf AD, et al. Musculoskeletal Health Conditions Represent a Global Threat to Healthy Aging: A Report for the 2015 World Health Organization World Report on Ageing and Health. Gerontologist. 2016;56(Suppl 2):243–55. · DOI
  7. O'Keeffe M, Purtill H, Kennedy N, Conneely M, Hurley J, O'Sullivan P, et al. Comparative Effectiveness of Conservative Interventions for Nonspecific Chronic Spinal Pain: Physical, Behavioral/Psychologically Informed, or Combined? A Systematic Review and Meta-Analysis. J Pain. 2016;17(7):755–74. · DOI
  8. Austad B, Hetlevik I, Mjolstad BP, Helvik AS. Applying clinical guidelines in general practice: a qualitative study of potential complications. BMC Fam Pract. 2016;17:92. · DOI
  9. Aasdahl L, Granviken F, Meisingset I, Woodhouse A, Evensen KAI. Recovery trajectories in common musculoskeletal complaints by diagnosis contra prognostic phenotypes. 2021;3:1–11.
  10. Foster NE, Hill JC, O'Sullivan P, Hancock M. Stratified models of care. Best Pract Res Clin Rheumatol. 2013;27(5):649–61. · DOI
  11. Hill JC, Whitehurst DG, Lewis M, Bryan S, Dunn KM, Foster NE, et al. Comparison of stratified primary care management for low back pain with current best practice (STarT Back): a randomised controlled trial. Lancet. 2011;378(9802):1560–71. · DOI · Paper page
  12. Stacey D, Legare F, Lewis K, Barry MJ, Bennett CL, Eden KB, et al. Decision aids for people facing health treatment or screening decisions. Cochrane Database Syst Rev. 2017;4(4):CD001431.
  13. Niburski K, Guadagno E, Abbasgholizadeh-Rahimi S, Poenaru D. Shared Decision Making in Surgery: A Meta-Analysis of Existing Literature. Patient. 2020;13(6):667–81. · DOI
  14. Sepucha KR, Atlas SJ, Chang Y, Freiberg A, Malchau H, Mangla M, et al. Informed, Patient-Centered Decisions Associated with Better Health Outcomes in Orthopedics: Prospective Cohort Study. Med Decis Making. 2018;38(8):1018–26. · DOI
  15. Knops AM, Legemate DA, Goossens A, Bossuyt PM, Ubbink DT. Decision aids for patients facing a surgical treatment decision: a systematic review and meta-analysis. Ann Surg. 2013;257(5):860–6. · DOI · Paper page
  16. Trenaman L, Stacey D, Bryan S, Taljaard M, Hawker G, Dervin G, et al. Decision aids for patients considering total joint replacement: a cost-effectiveness analysis alongside a randomised controlled trial. Osteoarthritis Cartilage. 2017;25(10):1615–22. · DOI
  17. Henschke N, Ostelo RW, Terwee CB, van der Windt DA. Identifying generic predictors of outcome in patients presenting to primary care with nonspinal musculoskeletal pain. Arthritis Care Res (Hoboken). 2012;64(8):1217–24. · DOI
  18. Green DJ, Lewis M, Mansell G, Artus M, Dziedzic KS, Hay EM, et al. Clinical course and prognostic factors across different musculoskeletal pain sites: A secondary analysis of individual patient data from randomised clinical trials. Eur J Pain. 2018;22(6):1057–70. · DOI
  19. Babatunde OO, Jordan JL, Van der Windt DA, Hill JC, Foster NE, Protheroe J. Effective treatment options for musculoskeletal pain in primary care: A systematic overview of current evidence. PLoS ONE. 2017;12(6):e0178621. · DOI
  20. Lin I, Wiles L, Waller R, Goucke R, Nagree Y, Gibberd M, et al. What does best practice care for musculoskeletal pain look like? Eleven consistent recommendations from high-quality clinical practice guidelines: systematic review. Br J Sports Med. 2020;54(2):79–86. · DOI
  21. Dunn KM, Campbell P, Lewis M, Hill JC, van der Windt DA, Afolabi E, et al. Refinement and validation of a tool for stratifying patients with musculoskeletal pain. Eur J Pain. 2021;25(10):2081–93. · DOI
  22. Hill JC, Garvin S, Bromley K, Saunders B, Kigozi J, Cooper V, et al. Risk-based stratified primary care for common musculoskeletal pain presentations (STarT MSK): a cluster-randomised, controlled trial. Lancet Rheumatol. 2022;4(9):e591–e602. · DOI
  23. Morken T, Rebnord IK, Maartmann-Moe K, Hunskaar S. Workload in Norwegian general practice 2018 – an observational study. BMC Health Serv Res. 2019;19(1):434. · DOI
  24. Hodes S, Hussain S, Salisbury H, Welch E, Whitaker P. GP crisis requires more than just technology to fix it. BMJ. 2022;378:o1670. · DOI
  25. Hill J, Garvin S, Chen Y, Cooper V, Wathall S, Bartlam B, et al. Computer-Based Stratified Primary Care for Musculoskeletal Consultations Compared With Usual Care: Study Protocol for the STarT MSK Cluster Randomized Controlled Trial. JMIR research protocols; 2020.
  26. Meisingset I, Vasseljen O, Vollestad NK, Robinson HS, Woodhouse A, Engebretsen KB, et al. Novel approach towards musculoskeletal phenotypes. Eur J Pain. 2020;24(5):921–32. · DOI
  27. Aasdahl L, Granviken F, Meisingset I, Woodhouse A, Evensen KAI, Vasseljen O. Recovery trajectories in common musculoskeletal complaints by diagnosis contra prognostic phenotypes. BMC Musculoskelet Disord. 2021;22(1):455. · DOI
  28. Chan AW, Tetzlaff JM, Altman DG, Laupacis A, Gøtzsche PC, Krleža-Jerić K, et al. SPIRIT 2013 statement: defining standard protocol items for clinical trials. Ann Intern Med. 2013;158(3):200–7. · DOI · Paper page
  29. Corp N, Mansell G, Stynes S, Wynne-Jones G, Morsø L, Hill JC, et al. Evidence-based treatment recommendations for neck and low back pain across Europe: A systematic review of guidelines. Eur J Pain. 2021;25(2):275–95. · DOI · Paper page
  30. Breivik H, Collett B, Ventafridda V, Cohen R, Gallacher D. Survey of chronic pain in Europe: Prevalence, impact on daily life, and treatment. Eur J Pain. 2006;10(4):287–333. · DOI · Paper page
  31. Mork PJ, Bach K. A Decision Support System to Enhance Self-Management of Low Back Pain: Protocol for the selfBACK Project. JMIR Res Protoc. 2018;7(7):e167. · DOI
  32. Campbell MK, Piaggio G, Elbourne DR, Altman DG, Group C. Consort 2010 statement: extension to cluster randomised trials. BMJ. 2012;345:e5661. · DOI · Paper page
  33. Kristoffersen ES, Bjorvatn B, Halvorsen PA, Nilsen S, Fossum GH, Fors EA, et al. The Norwegian PraksisNett: a nationwide practice-based research network with a novel IT infrastructure. Scand J Prim Health Care. 2022;40(2):217–26. · DOI
  34. Machado GC, Abdel-Shaheed C, Underwood M, Day RO. Non-steroidal anti-inflammatory drugs (NSAIDs) for musculoskeletal pain. BMJ. 2021;372:n104. · DOI
  35. Derry S, Conaghan P, Da Silva JA, Wiffen PJ, Moore RA. Topical NSAIDs for chronic musculoskeletal pain in adults. Cochrane Database Syst Rev. 2016;4(4):Cd007400.
  36. Derry S, Moore RA, Gaskell H, McIntyre M, Wiffen PJ. Topical NSAIDs for acute musculoskeletal pain in adults. Cochrane Database of Systematic Reviews. 2015;96(9):573–4.

Metadata

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., Windt, D. A. V. D., & Meisingset, I.
Affiliations
  • Norwegian University of Science and Technology (NO)
  • Keele University (GB)
  • Keele University School of Medicine
ORCID
Venue
Research Square
Publisher
Springer Science and Business Media LLC
Published
2023-03-13
DOI
10.21203/rs.3.rs-2608193/v1
OpenAlex
W4324046183
Cited by
2
References
3
Citations by year
2024: 2
Type
posted content
Language
en
Open access
Licence
Locations
  • Research Square (acceptedVersion, cc-by)
  • NORA - Norwegian Open Research Archives (submittedVersion, cc-by)
Funders
Norges Forskningsråd (303331, ref 303331)
Topics
  • Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › 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

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