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Mr Jonathan Price

Maximising Outcome For Patients With Shoulder Pain: Using Optimal Diagnostic And Prognostic Information To Target Treatment

Background: Shoulder pain is common? every year approximately 3% of adults in the United Kingdom (UK) consult their general practitioner (GP) for shoulder pain. The prognosis of shoulder pain is variable with 40-50% of patients reporting persistent pain 6-12 months after first consulting their general practitioner or physiotherapist, generating high costs to both healthcare and society.

Aims: This study will investigate if a personalized consultation by physiotherapists with self-management and treatment options guided by a structured assessment of individual patientsÂ’ needs, diagnosis and expected course of symptoms (prognosis) will improve patient outcomes and reduce healthcare costs compared to usual physiotherapy care.

Study design: Up to 16 physiotherapy services will be randomly allocated to the intervention or control arm of the trial. Physiotherapists in the intervention arm (8 services) will receive training and offer a guided personalized consultation to patients with shoulder pain. The other 8 physiotherapy services will continue to offer care as usual (control arm). Patients with shoulder pain who are on the waiting lists in these 16 services will be invited to take part in the study and complete questionnaires at baseline, after 6 weeks, 6 months and 12 months (more than 800 participants in total). Participants will be asked questions about their shoulder pain and its impact on everyday activities, sleep, work absence, and quality of life. Questions will also address their concerns about shoulder pain and the care they have received. In the intervention arm, around 20 patients and 10 physiotherapists will be interviewed about their views, expectations and experiences of the personalized guided consultation. A small number of participants (around 10) will be asked for consent for their consultation to be audio-recorded to assess how the guided intervention is delivered and if personalized self-management and treatment options are discussed and agreed.