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Talking in Primary Care (TIP): protocol for a cluster-randomised controlled trial in UK primary care to assess clinical and cost effectiveness of communication skills e-learning for practitioners on patients musculoskeletal pain and enablement

Talking in Primary Care (TIP): protocol for a cluster-randomised controlled trial in UK primary care to assess clinical and cost effectiveness of communication skills e-learning for practitioners on patients musculoskeletal pain and enablement
Talking in Primary Care (TIP): protocol for a cluster-randomised controlled trial in UK primary care to assess clinical and cost effectiveness of communication skills e-learning for practitioners on patients musculoskeletal pain and enablement

Introduction Effective communication can help optimise healthcare interactions and patient outcomes. However, few interventions have been tested clinically, subjected to cost-effectiveness analysis or are sufficiently brief and well-described for implementation in primary care. This paper presents the protocol for determining the effectiveness and cost-effectiveness of a rigorously developed brief eLearning tool, EMPathicO, among patients with and without musculoskeletal pain. Methods and analysis A cluster randomised controlled trial in general practitioner (GP) surgeries in England and Wales serving patients from diverse geographic, socioeconomic and ethnic backgrounds. GP surgeries are randomised (1:1) to receive EMPathicO e-learning immediately, or at trial end. Eligible practitioners (eg, GPs, physiotherapists and nurse practitioners) are involved in managing primary care patients with musculoskeletal pain. Patient recruitment is managed by practice staff and researchers. Target recruitment is 840 adults with and 840 without musculoskeletal pain consulting face-to-face, by telephone or video. Patients complete web-based questionnaires at preconsultation baseline, 1 week and 1, 3 and 6 months later. There are two patient-reported primary outcomes: pain intensity and patient enablement. Cost-effectiveness is considered from the National Health Service and societal perspectives. Secondary and process measures include practitioner patterns of use of EMPathicO, practitioner-reported self-efficacy and intentions, patient-reported symptom severity, quality of life, satisfaction, perceptions of practitioner empathy and optimism, treatment expectancies, anxiety, depression and continuity of care. Purposive subsamples of patients, practitioners and practice staff take part in up to two qualitative, semistructured interviews. Ethics approval and dissemination Approved by the South Central Hampshire B Research Ethics Committee on 1 July 2022 and the Health Research Authority and Health and Care Research Wales on 6 July 2022 (REC reference 22/SC/0145; IRAS project ID 312208). Results will be disseminated via peer-reviewed academic publications, conference presentations and patient and practitioner outlets. If successful, EMPathicO could quickly be made available at a low cost to primary care practices across the country. Trial registration number ISRCTN18010240.

digital technology, empathy, health communication, optimism, primary health care, Musculoskeletal disorders, MEDICAL EDUCATION & TRAINING, Patient-Centered Care, Primary Health Care, eHealth
2044-6055
Bishop, Felicity L.
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Cross, Nadia
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Dewar-Haggart, Rachel
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Teasdale, Emma
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Herbert, Amy
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Robinson, Michelle E.
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Ridd, Matthew J.
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Mallen, Christian D.
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Clarson, Lorna E.
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Bostock, Jennifer
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Becque, Taeko
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Stuart, Beth
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Garfield, Kirsty
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Morrison, Leanne
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Pollet, Sebastien
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Vennik, Jane
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Atherton, Helen
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Howick, Jeremy
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Leydon, Geraldine
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Nuttall, Jacqui
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Islam, Nazrul
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Lee, Paul H.
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Little, Paul
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Everitt, Hazel
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Bishop, Felicity L.
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Cross, Nadia
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Dewar-Haggart, Rachel
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Teasdale, Emma
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Herbert, Amy
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Robinson, Michelle E.
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Ridd, Matthew J.
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Mallen, Christian D.
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Clarson, Lorna E.
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Bostock, Jennifer
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Becque, Taeko
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Stuart, Beth
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Garfield, Kirsty
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Morrison, Leanne
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Pollet, Sebastien
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Vennik, Jane
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Atherton, Helen
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Howick, Jeremy
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Leydon, Geraldine
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Nuttall, Jacqui
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Islam, Nazrul
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Lee, Paul H.
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Little, Paul
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Everitt, Hazel
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Bishop, Felicity L., Cross, Nadia, Dewar-Haggart, Rachel, Teasdale, Emma, Herbert, Amy, Robinson, Michelle E., Ridd, Matthew J., Mallen, Christian D., Clarson, Lorna E., Bostock, Jennifer, Becque, Taeko, Stuart, Beth, Garfield, Kirsty, Morrison, Leanne, Pollet, Sebastien, Vennik, Jane, Atherton, Helen, Howick, Jeremy, Leydon, Geraldine, Nuttall, Jacqui, Islam, Nazrul, Lee, Paul H., Little, Paul and Everitt, Hazel (2024) Talking in Primary Care (TIP): protocol for a cluster-randomised controlled trial in UK primary care to assess clinical and cost effectiveness of communication skills e-learning for practitioners on patients musculoskeletal pain and enablement. BMJ Open, 14 (3), [e081932]. (doi:10.1136/bmjopen-2023-081932).

Record type: Article

Abstract

Introduction Effective communication can help optimise healthcare interactions and patient outcomes. However, few interventions have been tested clinically, subjected to cost-effectiveness analysis or are sufficiently brief and well-described for implementation in primary care. This paper presents the protocol for determining the effectiveness and cost-effectiveness of a rigorously developed brief eLearning tool, EMPathicO, among patients with and without musculoskeletal pain. Methods and analysis A cluster randomised controlled trial in general practitioner (GP) surgeries in England and Wales serving patients from diverse geographic, socioeconomic and ethnic backgrounds. GP surgeries are randomised (1:1) to receive EMPathicO e-learning immediately, or at trial end. Eligible practitioners (eg, GPs, physiotherapists and nurse practitioners) are involved in managing primary care patients with musculoskeletal pain. Patient recruitment is managed by practice staff and researchers. Target recruitment is 840 adults with and 840 without musculoskeletal pain consulting face-to-face, by telephone or video. Patients complete web-based questionnaires at preconsultation baseline, 1 week and 1, 3 and 6 months later. There are two patient-reported primary outcomes: pain intensity and patient enablement. Cost-effectiveness is considered from the National Health Service and societal perspectives. Secondary and process measures include practitioner patterns of use of EMPathicO, practitioner-reported self-efficacy and intentions, patient-reported symptom severity, quality of life, satisfaction, perceptions of practitioner empathy and optimism, treatment expectancies, anxiety, depression and continuity of care. Purposive subsamples of patients, practitioners and practice staff take part in up to two qualitative, semistructured interviews. Ethics approval and dissemination Approved by the South Central Hampshire B Research Ethics Committee on 1 July 2022 and the Health Research Authority and Health and Care Research Wales on 6 July 2022 (REC reference 22/SC/0145; IRAS project ID 312208). Results will be disseminated via peer-reviewed academic publications, conference presentations and patient and practitioner outlets. If successful, EMPathicO could quickly be made available at a low cost to primary care practices across the country. Trial registration number ISRCTN18010240.

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Accepted/In Press date: 1 March 2024
e-pub ahead of print date: 19 March 2024
Published date: 19 March 2024
Additional Information: © Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY. Published by BMJ.
Keywords: digital technology, empathy, health communication, optimism, primary health care, Musculoskeletal disorders, MEDICAL EDUCATION & TRAINING, Patient-Centered Care, Primary Health Care, eHealth

Identifiers

Local EPrints ID: 487846
URI: http://eprints.soton.ac.uk/id/eprint/487846
ISSN: 2044-6055
PURE UUID: 5f0d9422-a58a-4f1e-8c72-d0d161109940
ORCID for Felicity L. Bishop: ORCID iD orcid.org/0000-0002-8737-6662
ORCID for Nadia Cross: ORCID iD orcid.org/0000-0002-4148-7180
ORCID for Rachel Dewar-Haggart: ORCID iD orcid.org/0000-0002-3757-1152
ORCID for Emma Teasdale: ORCID iD orcid.org/0000-0001-9147-193X
ORCID for Taeko Becque: ORCID iD orcid.org/0000-0002-0362-3794
ORCID for Beth Stuart: ORCID iD orcid.org/0000-0001-5432-7437
ORCID for Leanne Morrison: ORCID iD orcid.org/0000-0002-9961-551X
ORCID for Sebastien Pollet: ORCID iD orcid.org/0000-0001-9924-9225
ORCID for Jane Vennik: ORCID iD orcid.org/0000-0003-4602-9805
ORCID for Helen Atherton: ORCID iD orcid.org/0000-0002-7072-1925
ORCID for Geraldine Leydon: ORCID iD orcid.org/0000-0001-5986-3300
ORCID for Nazrul Islam: ORCID iD orcid.org/0000-0003-3982-4325
ORCID for Paul H. Lee: ORCID iD orcid.org/0000-0002-5729-6450
ORCID for Paul Little: ORCID iD orcid.org/0000-0003-3664-1873
ORCID for Hazel Everitt: ORCID iD orcid.org/0000-0001-7362-8403

Catalogue record

Date deposited: 06 Mar 2024 17:47
Last modified: 06 Mar 2026 05:24

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Contributors

Author: Nadia Cross ORCID iD
Author: Emma Teasdale ORCID iD
Author: Amy Herbert
Author: Michelle E. Robinson
Author: Matthew J. Ridd
Author: Christian D. Mallen
Author: Lorna E. Clarson
Author: Jennifer Bostock
Author: Taeko Becque ORCID iD
Author: Beth Stuart ORCID iD
Author: Kirsty Garfield
Author: Leanne Morrison ORCID iD
Author: Jane Vennik ORCID iD
Author: Helen Atherton ORCID iD
Author: Jeremy Howick
Author: Jacqui Nuttall
Author: Nazrul Islam ORCID iD
Author: Paul H. Lee ORCID iD
Author: Paul Little ORCID iD
Author: Hazel Everitt ORCID iD

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