Collaborative Clinical Reasoning: Perceptions and Practices of General Practitioners, Physical Therapists, and Patients With Low Back Pain in Primary Care
Low back pain is a major health problem in primary care and is associated with a substantial clinical, economic, and societal burden. Although evidence-based recommendations are available, its management remains heterogeneous, poorly coordinated, and often characterized by overmedicalization. In this context, interprofessional collaboration has been identified as a means of improving primary care but does not necessarily ensure a shared understanding of clinical situations. Collaborative Clinical Reasoning (CCR), defined as the process of developing a shared mental model among healthcare professionals and patient partners, remains insufficiently explored in primary care.
This exploratory qualitative study aims to explore the representations and definitions of Collaborative Clinical Reasoning among general practitioners, physiotherapists, and patient partners with low back pain in French-speaking Belgium. It also aims to examine how CCR is implemented in primary care practice and to identify perceived barriers and facilitators to its implementation.
Data will be collected through separate focus groups involving general practitioners, physiotherapists, and patient partners with low back pain. Qualitative data will be analyzed using inductive reflexive thematic analysis.
Study Overview
Status
Conditions
Intervention / Treatment
Study Type
Enrollment (Estimated)
Phase
- Not Applicable
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
A. General Practitioners
- Be a general practitioner or a physician in postgraduate training in general practice.
- Practice general medicine in French-speaking Belgium.
- Practice general medicine in primary care.
B. Physiotherapists
- Be a physiotherapist.
- Practice physiotherapy in French-speaking Belgium.
- Practice physiotherapy in primary care.
C. Patients with low back pain
- Age ≥18 years.
- Have low back pain (pain between the lower margin of the ribs and the gluteal fold, with or without pain in one or both legs).
- Have consulted both a general practitioner and a physiotherapist for this condition in primary care in French-speaking Belgium.
Exclusion Criteria:
A. General Practitioners
1. Be on sick leave during the study (e.g., work incapacity)
B. Physiotherapists
- Practice exclusively in a nursing home or a nursing home with skilled nursing care.
- Be on sick leave during the study (e.g., work incapacity).
C. Patients with low back pain
- Have a known specific lumbar pathology (e.g., fracture, infection, cancer, lumbar radiculopathy, etc).
- Have a known general condition that may explain the low back pain (e.g., fibromyalgia, osteoporosis, rheumatologic disease, etc).
- Have undergone back surgery within the past 12 months.
- Be pregnant or have had a known pregnancy within the past 12 months.
- Reside in a nursing home or a nursing home with skilled nursing care.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Health Services Research
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
|---|---|
|
Other: General Practitioners, Physiotherapists, and Patients with non-specific low back
|
General practitioners, physiotherapists, and patients will first participate in separate focus groups for each stakeholder group.
A subsequent mixed deliberative workshop will bring together participants from the three stakeholder groups to discuss and refine the findings.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Participants' representations and definitions of Collaborative Clinical Reasoning, identified through reflexive thematic analysis.
Time Frame: From the initial focus groups to the subsequent deliberative workshop, over an estimated 15-month data collection period.
|
Participants' representations and definitions of Collaborative Clinical Reasoning will be explored through qualitative data collected during separate focus groups with general practitioners, physiotherapists, and patients with non-specific low back pain, as well as during a subsequent deliberative workshop bringing together these three participant groups.
|
From the initial focus groups to the subsequent deliberative workshop, over an estimated 15-month data collection period.
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Enactment of Collaborative Clinical Reasoning in primary care practice, identified through reflexive thematic analysis.
Time Frame: From the initial focus groups to the subsequent deliberative workshop, over an estimated 15-month data collection period.
|
The enactment of Collaborative Clinical Reasoning in primary care practice will be explored through qualitative data collected during separate focus groups with general practitioners, physiotherapists, and patients with non-specific low back pain, as well as during a subsequent deliberative workshop bringing together these three participant groups.
|
From the initial focus groups to the subsequent deliberative workshop, over an estimated 15-month data collection period.
|
|
Barriers and facilitators to the enactment of Collaborative Clinical Reasoning in primary care practice, identified through reflexive thematic analysis.
Time Frame: From the initial focus groups to the subsequent deliberative workshop, over an estimated 15-month data collection period.
|
Barriers and facilitators influencing the enactment of Collaborative Clinical Reasoning in primary care practice will be explored through qualitative data collected during separate focus groups with general practitioners, physiotherapists, and patients with non-specific low back pain, as well as during a subsequent deliberative workshop bringing together these three participant groups.
|
From the initial focus groups to the subsequent deliberative workshop, over an estimated 15-month data collection period.
|
Collaborators and Investigators
Sponsor
Study record dates
Study Major Dates
Study Start (Estimated)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Pain
- Neurologic Manifestations
- Back Pain
- Pathological Conditions, Signs and Symptoms
- Signs and Symptoms
- Low Back Pain
- Health Care Quality, Access, and Evaluation
- Investigative Techniques
- Epidemiologic Methods
- Data Collection
- Health Care Evaluation Mechanisms
- Quality of Health Care
- Public Health
- Environment and Public Health
- Focus Groups
Other Study ID Numbers
- RCC
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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