Effectiveness of Two Different Entry Portal Pathways Into Primary Care for Musculoskeletal Injury

Effectiveness of Two Different Entry Portal Pathways Into Primary Care for Musculoskeletal Injury: A Randomized Controlled Trial

This study aims to compare the self-report functional outcome measures, medical readiness and healthcare utilization (overall cost of imaging, prescription medications for pain, and follow-up visits) of soldiers with musculoskeletal injuries first seen by a physical therapist versus primary care provider.

Study Overview

• Status: Unknown
• Conditions: Physical Therapy Direct Access; Physical Therapy Primary Care
• Intervention / Treatment: Other: physical therapy vs. primary care interventions

• Study Type: Interventional
• Enrollment (Actual): 53
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Oklahoma
    • Fort Sill, Oklahoma, United States, 73053
      • Reynolds Army Community Hospitral

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Adults over age 18
• Musculoskeletal injury or complaint < 3 months since onset
• Active duty service member, reachable by phone/e-mail within 3 months of initial encounter

Exclusion Criteria:

• Subject currently has a permanent profile for any reason OR subject has a temporary profile for a body part in the same half of the body as the current complaint OR solider is pending physical examination board (PEB) or undergoing/pending medical examination board (MEB)
• Individuals undergoing PEB/MEB are made aware that the end-state of the process includes a certain percentage of government monetary compensation based on their physical or mental disability, i.e, higher disability equates to greater pay. Because of this, individuals may be motivated to demonstrate worse outcomes as it may result in a higher disability "rating". For this reason, these individuals will be excluded from the study.
• Subject has been treated previously for the same condition within the past 3 months
• Subject has history of surgery for the same body part within the past 24 months

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Triple

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Physical Therapy route of entry; The subject will see a physical therapist as their initial encounter into the healthcare system	Other: physical therapy vs. primary care interventions; Subjects with acute (< 3 months onset) will be randomized to see either a physical therapist or a primary care provider as their initial entry into the healthcare system
Active Comparator: Primary Care Provider rout of entry; The subject will see a primary care provider as their initial encounter into the healthcare system	Other: physical therapy vs. primary care interventions; Subjects with acute (< 3 months onset) will be randomized to see either a physical therapist or a primary care provider as their initial entry into the healthcare system

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Patient Specific Functional Scale	3 months
PROMIS physical function scale	3 months
Global Rating of Change (GROC)	3 months
Defense and Veterans Pain Rating Scale	3 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Self-Report Medical Readiness Questionnaire	This questionnaire consists of 6 questions that ask the patient to rate their ability to perform various soldier/deployment-related tasks. This will provide way of measuring the soldier's perceived status of medical readiness before and after episodes of medical care.	3 months
Medical Profile Status	The medical profile is the Army's assessment of a soldier's overall medical readiness, i.e.: deployability. A profile for musculoskeletal injury can be temporary (T) or permanent (P) and deployable (2) or non-deployable (3). The profile is used to limit the soldier's activities to accommodate their injury or complaint. Evaluating the medical profile status in this study will serve as a way to measure the subjects' medical readiness.	3 months
Overall Healthcare Consumption	overall healthcare consumption as measured by the dollar-value of each medical encounter following the initial encounter	12 months
Patient Satisfaction	Likert Scale 0-10, how satisfied is the patient with the care they received.	3 months
Report of adverse events		3 months

Collaborators and Investigators

• Sponsor: Reynolds Army Community Hospital
• Collaborators: Temple University; Brooke Army Medical Center

Study record dates

Study Major Dates

• Study Start (Actual): January 1, 2016
• Primary Completion (Actual): August 1, 2017
• Study Completion (Anticipated): August 1, 2018

Study Registration Dates

• First Submitted: January 11, 2016
• First Submitted That Met QC Criteria: April 1, 2016
• First Posted (Estimate): April 4, 2016

Study Record Updates

• Last Update Posted (Actual): November 29, 2017
• Last Update Submitted That Met QC Criteria: November 27, 2017
• Last Verified: November 1, 2017

More Information

Terms related to this study

• Other Study ID Numbers: 413803-1