What is the Effect of a Course for Treatment Providers on Their Patient Outcome

Does Training in Psychosocial Methods for Treatment Providers Improve Outcome for Pain Patients at Risk of Long-Term Disability? A Randomised Controlled Trail of a Course for Physical Therapists

The goal is to acquire more in-depth knowledge on physical therapists' attitudes towards and beliefs about psychosocial factors in back pain, how physical therapists integrate psychosocial factors into their clinical practice and the effects of a training program for physical therapists in psychosocial factors on clinical practice and thereby on patient outcome in terms of disability, pain, catastrophizing, and treatment satisfaction.

Study Overview

• Status: Completed
• Conditions: Pain
• Intervention / Treatment: Behavioral: an eight day university training course designed to integrating psychosocial factors in clinical practice on a patient level

Detailed Description

Neck and back pain continue to be extremely common, with a high prevalence and wide socio-economic consequences all over the industrialized world. Through the years a growing interest has risen for other factors than the pure biomedical or biomechanical. This has led to a new clinical model for the treatment of back pain; the biopsychosocial model of illness. Treatment based on the biopsychosocial model not only must address the biological basis of symptoms, but must incorporate the full range of social and psychological factors that have been shown to affect pain, distress and disability.

Since there is today strong evidence indicating that psychosocial factors have a greater impact on disability then biomechanical or biomedical factors and strong evidence that psychosocial factors are strongly linked to the transition from acute to chronic pain, concept of psychosocial risk factors has been developed. Although the concept of psychosocial risk factors still is relatively new, there seems to be an international consensus about the importance of psychosocial risk factors for the prevention of the development of chronic pain but there appears to be considerable uncertainty about the clinical application.

Health care providers' (HCPs') attitudes and beliefs appear to influence the information they provide to patients. This may subsequently result in different patient outcome depending on the HCPs' attitudes and beliefs. Physical therapists attitudes and beliefs are relatively unexplored but seem to have an effect on patients' attitudes and beliefs, which can affect patient outcome in terms of sick leave, health care use and function.

HCP attitudes and beliefs towards psychosocial factors are relatively unexplored. Yet, it seems physical therapists do not necessarily accept new evidence-based information and may have difficulties in applying evidence-based information in their clinical practice. Implementation and dissemination of evidence-based psychosocial factors requires favourable attitudes, knowledge and skills to ensure a behavioural change on behave of the physical therapists.

• Study Type: Interventional
• Enrollment (Actual): 364
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Sweden
  • Eskilstuna, Sweden
    • Mälardalens högskola

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 65 years (ADULT, OLDER_ADULT)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Musculoskeletal pain,
• Age between 18 and 65

Exclusion Criteria:

• Sick leave for more than 3 months during the past year as a result of present the musculoskeletal pain problem

Study Plan

How is the study designed?

Design Details

• Primary Purpose: TREATMENT
• Allocation: RANDOMIZED
• Interventional Model: CROSSOVER
• Masking: NONE

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
NO_INTERVENTION: control group
ACTIVE_COMPARATOR: Course on psychosocial factors; an eight day university training course for physical therapists designed to integrating psychosocial factors in clinical practice on a patient level	Behavioral: an eight day university training course designed to integrating psychosocial factors in clinical practice on a patient level; an eight day university training course on psychosocial factors for physical therapists

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Disability	treatment start and 6 month follow up

Secondary Outcome Measures

Outcome Measure	Time Frame
catastrophizing	treatment start and 6 month follow up
treatment satisfaction	6 month follow up
satisfaction with treatment result	6 month follow up
Pain	treatment start and 6 month follow up

Collaborators and Investigators

• Sponsor: Örebro County Council
• Collaborators: Örebro University, Sweden; School of Law, Psychology, and Social Work, Örebro University, Sweden
• Investigators: Study Director: Steven J Linton, PH.D., Center for Health and Medical Psychology and School of Law, Psychology, and Social Work, Örebro University, Sweden

Publications and helpful links

General Publications

• Overmeer T, Boersma K, Denison E, Linton SJ. Does teaching physical therapists to deliver a biopsychosocial treatment program result in better patient outcomes? A randomized controlled trial. Phys Ther. 2011 May;91(5):804-19. doi: 10.2522/ptj.20100079. Epub 2011 Mar 30.

Study record dates

Study Major Dates

• Study Start: September 1, 2004
• Primary Completion (ACTUAL): August 1, 2006
• Study Completion (ACTUAL): August 1, 2006

Study Registration Dates

• First Submitted: May 13, 2009
• First Submitted That Met QC Criteria: May 13, 2009
• First Posted (ESTIMATE): May 15, 2009

Study Record Updates

• Last Update Posted (ESTIMATE): May 15, 2009
• Last Update Submitted That Met QC Criteria: May 13, 2009
• Last Verified: May 1, 2009

More Information

Terms related to this study

• Keywords: education; Physical therapy,; musculoskeletal pain,; psychosocial factors,; dissimilation,; evidence based,
• Other Study ID Numbers: M-127