Research Supervisor Connect
This is a PhD opportunity to work on a MRFF-funded trial evaluating primary contact physiotherapy in emergency departments.
North Shore - Northern Clinical School
Musculoskeletal conditions, including back pain, are in the top 10 reason for presentation to Australian emergency departments (ED). There is some evidence that timely access to physiotherapy in EDs reduces wait-time, and ED length of stay. Primary contact physiotherapists have been present in some Australian EDs for approximately 20 years, however the level of service provision varies across sites and access is inequitable. This may be because strong evidence of effectiveness is lacking, i.e. predominately observational studies.
The trial aims to test the effectiveness, cost-effectiveness, and scalability of a primary contact physiotherapy service in managing musculoskeletal conditions in the ED.
This is a two-arm, parallel randomised controlled trial with nested process and economic evaluations. 620 participants will be randomised to receive primary contact physiotherapy management or usual care (i.e. managed predominantly by doctors and nursing staff). Inclusion criteria will be any adult patient (>18 years) that presents to the ED with a simple musculoskeletal condition. This would include but not limited to low back and neck pain, joint pain, muscle sprains and strains.
The primary outcome will be ED length of stay to measure patient flow. Secondary outcomes include patient reported measures of pain intensity (numeric rating scale 0-10), quality of life (Euro-Qol 5D-5L), satisfaction with care (scale 0-10), adverse events or unintended consequences, and health services outcomes of healthcare use and costs.
Process measures will explore the scalability of this intervention, if shown to be effective and cost-effective. These include acceptability, appropriateness, and fidelity. Process outcomes will be measured through trial logs and semi-structured interviews with the ED clinicians and managers.
If the intervention is effective, we plan to work with our partners at the Emergency Care Institute (ECI) to implement across NSW. A successful intervention to improve patient flow would reduce the pressure emergency departments are facing.
A PhD stipend is available for this opportunity. This trial is funded in the 2022 Models of Care to Improve the Efficiency and Effectiveness of Acute Care Grant Opportunity (MRF2018280, $2,818,123).
Additional Supervisor: Professor Christopher Maher
The opportunity ID for this research opportunity is 3257