BMJ Open (Mar 2025)
Effectiveness of primary-contact physiotherapy in managing musculoskeletal conditions in emergency departments: protocol for the RESHAP-ED randomised controlled trial
- ,
- Rachelle Buchbinder,
- Andrew Lawson,
- Bethan Richards,
- Kirsten Howard,
- Vasi Naganathan,
- Michael Dinh,
- Kirsten McCaffery,
- Thomas Lung,
- Laurent Billot,
- Ian Harris,
- Gustavo C Machado,
- James Edwards,
- Eileen Rogan,
- Andrew Wong,
- John Wiggers,
- Chris Maher,
- Danielle Coombs,
- Narcyz Ghinea,
- Leigh Kinsman,
- Christopher Williams,
- Tarcisio F de Campos,
- Chelsea Hall,
- Lisa Harvey,
- Hatem Alkhouri,
- Katherine Maka,
- Teresa Anderson,
- Andrew Bailey,
- Chathurani Sigera,
- Qiuzhe Chen,
- Alla Melman,
- Allison Moore,
- Owen Hutchings,
- Helen Goldsmith,
- John-Paul Smiles,
- Gabriel Lau,
- Peter Youseff,
- Ian Liang,
- Chantay Lenord,
- Ruth Perrott,
- Julie Penn,
- Stephen Spennati,
- Rebecca Ormerod,
- Samuel Folbigg,
- Laura Butterworth,
- Frederico Estermann,
- Sarah Attree,
- Samuel Boughton,
- Prue Neely,
- Amy Wigham,
- Angelo Efthimiou,
- Hui-Te Ku,
- Sarah Kammoun,
- Breanna Frendo,
- Patrick Law,
- Sharon Xu
Affiliations
- Rachelle Buchbinder
- 13 School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Andrew Lawson
- Bethan Richards
- 4 Institute for Musculoskeletal Health, The University of Sydney, Sydney, New South Wales, Australia
- Kirsten Howard
- 9 Menzies Centre for Health Policy and Economics, University of Sydney, Sydney, New South Wales, Australia
- Vasi Naganathan
- Concord Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
- Michael Dinh
- 6 NSW Institute of Trauma and Injury Management, NSW Agency for Clinical Innovation, Sydney, New South Wales, Australia
- Kirsten McCaffery
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Thomas Lung
- 3 Dr Risch Medical Laboratory, Buchs, Switzerland
- Laurent Billot
- 11 The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
- Ian Harris
- Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, UNSW, Sydney, New South Wales, Australia
- Gustavo C Machado
- 3 Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, New South Wales, Australia
- James Edwards
- Emergency Department, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
- Eileen Rogan
- 2 Canterbury Hospital, Campsie, New South Wales, Australia
- Andrew Wong
- John Wiggers
- professor
- Chris Maher
- School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
- Danielle Coombs
- 1 Institute for Musculoskeletal Health, Sydney Local Health District, Sydney, New South Wales, Australia
- Narcyz Ghinea
- Department of Philosophy, Macquarie University, Sydney, New South Wales, Australia
- Leigh Kinsman
- 1 University of Tasmania, Launceston, Tasmania, Australia
- Christopher Williams
- Public Health Wales, Communicable Disease Surveillance Centre, Cardiff, UK
- Tarcisio F de Campos
- 1 Institute for Musculoskeletal Health, Sydney Local Health District, Sydney, New South Wales, Australia
- Chelsea Hall
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Lisa Harvey
- John Walsh Centre for Rehabilitation Research, Northern Clinical School, The University of Sydney, St Leonards, New South Wales, Australia
- Hatem Alkhouri
- Emergency Care Institute, Agency for Clinical Innovation, Sydney, New South Wales, Australia
- Katherine Maka
- 2 Western Sydney Local Health District, Wentworthville, New South Wales, Australia
- Teresa Anderson
- Chief Executive, Sydney Local Health Network, Liverpool Hospital, Liverpool, Australia
- Andrew Bailey
- Chathurani Sigera
- Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
- Qiuzhe Chen
- doctoral student
- Alla Melman
- The University of Sydney, Sydney Musculoskeletal Health, Camperdown, New South Wales, Australia
- Allison Moore
- University of Colorado Anschutz Medical Campus School of Medicine, Aurora, Colorado, USA
- Owen Hutchings
- Helen Goldsmith
- John-Paul Smiles
- Gabriel Lau
- Peter Youseff
- Ian Liang
- Chantay Lenord
- Ruth Perrott
- Julie Penn
- Stephen Spennati
- Rebecca Ormerod
- Samuel Folbigg
- Laura Butterworth
- Frederico Estermann
- Sarah Attree
- Samuel Boughton
- Prue Neely
- Amy Wigham
- Angelo Efthimiou
- Hui-Te Ku
- Sarah Kammoun
- Breanna Frendo
- Patrick Law
- Sharon Xu
- DOI
- https://doi.org/10.1136/bmjopen-2024-096044
- Journal volume & issue
-
Vol. 15,
no. 3
Abstract
Introduction Patients with musculoskeletal conditions often seek care in an emergency department (ED). The problem is that the time required to manage these patients places an additional pressure on ED physician and nursing staff, who are primarily trained and resourced to manage high-acuity patients. Primary-contact physiotherapists could play a greater role in supporting ED physician and nursing staff in the management of patients presenting to the ED with musculoskeletal conditions.Methods and analysis The RESHAP-ED trial is a multicentre, pragmatic, open-label, two-arm, parallel randomised controlled trial with nested process and economic evaluations. The trial will investigate whether a primary-contact physiotherapy pathway compared with usual care (primary-contact by physician and/or nursing staff pathway) reduces time spent in ED. Patients with simple musculoskeletal conditions will be recruited from EDs in New South Wales, Australia. The primary outcome is ED length of stay (LOS). Secondary outcomes will include acceptability, feasibility and cost-effectiveness of primary-contact physiotherapy, and explore patients’ and clinicians’ experience. To detect a 30 min between-group difference in ED LOS, 1370 patients will be required. Analyses of the primary and secondary outcomes will be conducted following the intention-to-treat principle. The adjusted mean difference in ED LOS and 95% CI will be calculated using linear regression adjusted for hospital using a random effect model.Ethics and dissemination The study received ethical approval from the Sydney Local Health District (RPAH zone) Human Research Ethics Committee (X23-0143). Findings from this study will be disseminated through publication in peer-reviewed journals and conference presentations.Trial registration number Australia New Zealand Clinical Trials Registry: ACTRN 12623000782639; Universal Trial Number (UTN): U1111-1292-2883.
