To investigate whether a physiotherapist-led triage and treatment service is non-inferior for improving function at 6-months, and superior for reducing treatment waiting times, compared to usual care for patients with musculoskeletal pain referred to public hospital outpatient physiotherapy clinics.
368 participants (184 per arm) will be recruited from six public hospitals located in metropolitan Sydney, Australia. We will recruit adult patients newly referred to a public hospital physiotherapy outpatient clinic with a musculoskeletal condition that is typically managed by a physiotherapist (e.g. back or neck pain, osteoarthritis, rehabilitation post-orthopaedic surgery, sporting injuries). Participants will be randomised 1:1 to the physiotherapist-led triage and treatment service or usual care. A physiotherapist will telephone new referrals in the intervention group and match them to different modes and types of care based on baseline characteristics.
Participants at low risk of poor outcome (assessed by the Keele STarT MSK tool) will be given simple advice and education during this call and instructed to call back if their symptoms do not improve in 6 weeks. Participants at medium risk of poor outcome or requiring post-operative rehabilitation will be offered a course of telehealth (videoconference) physiotherapy targeting exercise-based self-management. Participants at high risk of poor outcome and/or with potential non-progressive radiculopathy will be offered a course of usual clinic-based physiotherapy, as per all participants in the usual care group. Physical function (Patient Specific Functional Scale) at 6 months post-randomisation and waiting time (time from randomisation to treatment) are co-primary outcomes. Secondary outcomes include other patient outcomes (e.g. pain), health resource use, adverse events, process measures (e.g. adherence) and costs.
Yet to commence recruitment of participants.
The WAIT-less trial will determine whether a physiotherapist-led triage and treatment service is non-inferior in terms of improving function at 6-months, and superior for reducing treatment waiting times, when compared to usual clinic-based care for patients with musculoskeletal pain referred to public hospital outpatient physiotherapy clinics.
The findings of this trial will establish whether a novel early triage model of care in public hospital outpatient physiotherapy clinics can help overcome a key health service delivery challenge in the management of musculoskeletal pain in Australia.
Musculoskeletal
Telehealth
