Comparing Standard Care Approaches for Greater Trochanteric Pain Syndrome in General Practice

Patient information leaflet on GTPS and load management, handed out at baseline with brief oral information.

Participants receive a patient information leaflet describing the GTPS condition and emphasising self-management, particularly load management. The leaflet is based on material from a recent randomised trial (the LEAP trial), translated into Danish and adapted to a Danish context through input from clinicians and patients with GTPS. At baseline, the leaflet is handed out together with a brief verbal summary of the key points. A follow-up phone call is made approximately one week after baseline to address any questions regarding the assigned intervention

Patient information leaflet plus a home exercise programme (hip bridge, hip abduction, squat) performed three times a week, with written instructions, online videos and a training diary.

Participants receive a patient information leaflet describing the GTPS condition and emphasising self-management, particularly load management. The leaflet is based on material from a recent randomised trial (the LEAP trial), translated into Danish and adapted to a Danish context through input from clinicians and patients with GTPS. At baseline, the leaflet is handed out together with a brief verbal summary of the key points. A follow-up phone call is made approximately one week after baseline to address any questions regarding the assigned intervention

Participants receive a home-based strength exercise programme in addition to the patient information leaflet. The programme consists of three body-weight exercises (hip bridge, hip abduction and squat) to be performed three times per week. At baseline, participants receive a brief standardised verbal introduction of approximately 10 minutes covering key exercises, technique and progression principles. Written instructions with pictures, access to online instruction videos and a training diary are also provided. Participants are instructed to continue exercising until they reach a personally acceptable symptom level, and for an additional four weeks thereafter. Exercise adherence is monitored using the training diary. A follow-up phone call is made approximately one week after baseline to address any questions regarding the exercise programme.

Patient information leaflet and home exercise programme plus an ultrasound-guided corticosteroid injection at the gluteal tendon insertion no later than 7 days after baseline, with optional repeat injection at 6 weeks if NRS >4.

Participants receive a patient information leaflet describing the GTPS condition and emphasising self-management, particularly load management. The leaflet is based on material from a recent randomised trial (the LEAP trial), translated into Danish and adapted to a Danish context through input from clinicians and patients with GTPS. At baseline, the leaflet is handed out together with a brief verbal summary of the key points. A follow-up phone call is made approximately one week after baseline to address any questions regarding the assigned intervention

Participants receive a home-based strength exercise programme in addition to the patient information leaflet. The programme consists of three body-weight exercises (hip bridge, hip abduction and squat) to be performed three times per week. At baseline, participants receive a brief standardised verbal introduction of approximately 10 minutes covering key exercises, technique and progression principles. Written instructions with pictures, access to online instruction videos and a training diary are also provided. Participants are instructed to continue exercising until they reach a personally acceptable symptom level, and for an additional four weeks thereafter. Exercise adherence is monitored using the training diary. A follow-up phone call is made approximately one week after baseline to address any questions regarding the exercise programme.

Participants receive an ultrasound-guided corticosteroid injection (1 ml triamcinolone 40 mg/ml and 1 ml lidocaine 10 mg/ml) at the insertion of the gluteal tendons on the greater trochanter of the affected hip, administered by a specialist in rheumatology no later than 7 days after the baseline visit. If pain persists at the 6-week follow-up (NRS >4), a repeat injection may be offered. Participants are instructed to begin the exercise programme the day after the injection or as soon as any post-injection pain flare has resolved.

Proportion of participants reporting "much better" or "very much better" on the GROC, a 7-point scale ranging from "very much worse" to "very much better"

Self-reported average hip pain intensity over the previous week on an 11-point scale ranging from 0 (no pain) to 10 (worst pain imaginable). Higher scores indicate greater pain intensity.

Self-reported worst experienced night pain over the previous week on an 11-point scale ranging from 0 (no pain) to 10 (worst pain imaginable). Higher scores indicate greater pain intensity.

Self-reported percentage of time pain has been present during the previous week, ranging from 0% (no time in pain) to 100% (in pain at all times). Higher scores indicate more time spent in pain.

Self-reported hip-related disability measured on a scale ranging from 0 to 100. Higher scores indicate better function and less pain.

Self-reported functional level for up to five patient-selected activities, each rated on a scale from 0 (unable to perform) to 10 (able to perform at pre-injury level). A mean score is calculated across activities. Higher scores indicate better function.

Self-reported confidence in performing activities while in pain, measured on a scale ranging from 0 to 60. Higher scores indicate greater pain self-efficacy.

Health-related quality of life measured as a utility score ranging from -0.624 (worst imaginable health) to 1 (best imaginable health), calculated using Danish population preference weights, and a visual analogue scale ranging from 0 (worst imaginable health) to 100 (best imaginable health). For both calculations, a higher scores indicates better health.

Self-reported physical activity level expressed as MET-minutes per week, calculated as MET level multiplied by minutes and days per week. Higher scores indicate greater physical activity.

Proportion of participants reporting a symptom level acceptable enough not to require further treatment. Participants are considered to have achieved PASS if they answer "yes" to the question "Is your lateral hip pain at an acceptable level that does not require any further treatment?" Time to first PASS will also be recorded.

Number of participants with adverse events graded by type, severity and causality. Severity is graded on a scale from 1 (mild) to 5 (death).

Healthcare utilisation, productivity losses and out-of-pocket expenses captured via patient-reported questionnaires, including a modified version of the Oslo Cost Questionnaire (OCC-Q). Quality-adjusted life years (QALYs) calculated from EQ-5D-5L responses using Danish population preference weights, summarised at societal and healthcare system level.