Implementation of a novel stratified PAthway of CarE for common musculoskeletal (MSK) conditions in primary care: protocol for a multicentre pragmatic randomised controlled trial (the PACE MSK trial)

Purpose Previous research indicates that the compensation process is stressful for people with a compensable injury, contributing to poorer recovery. However, little is known about the challenges faced by clinicians who work in this setting. This study aims to qualitatively explore the experiences of clinicians delivering care to patients with compensable injuries in Australia. Materials and methods Semi-structured interviews were conducted with 26 experienced clinicians providing care to compensable patients in Australia. The interviews were transcribed, and data were analysed using reflective thematic analysis. Results Participants described their work as challenging due to factors such as high patient distress, poor clinical outcomes, and high administrative load. However, they responded to these challenges in varying ways. While some reported feelings of vicarious injustice, emotional exhaustion, and self-doubt, others derived a sense of meaning, purpose, and mastery from these challenges. Clinician responses to the challenge of working with people with a compensation claim were associated with access to mentoring, continuous education and training, and a supportive workplace culture. Conclusion Clinicians reported both positive and negative responses to the challenges of working with people with a compensable injury. Understanding individual and workplace factors shaping clinician responses to the demands of working with compensable patients may be crucial for retaining the clinical workforce and improving access to compensable care.

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Evaluation of the acceptability and feasibility of stress mitigation education and support delivered via telehealth for people after road traffic musculoskeletal/orthopaedic injury

Sim,

McNeilage,

Rebbeck

et al. 2024

Preprint

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Purpose To evaluate the acceptability and feasibility of a consumer co-designed telehealth intervention which aimed to reduce claimant distress by providing pain management strategies, informational and social support to people who had made a compensation claim following road traffic musculoskeletal injury. Methods Eleven claimant participants who were at risk of a poor outcome completed the intervention and were interviewed about their experience (acceptability and feasibility including the use of telehealth). Clinicians who delivered the intervention also completed an anonymous feedback survey exploring their experiences delivering the intervention. Interviews were transcribed verbatim and thematic analysis was conducted. Results There were four themes which broadly related to the acceptability and feasibility of the intervention as well as the perceived benefits: (1) knowledge is power, (2) healing with social connection, (3) further along than I would have been and (4) telehealth was acceptable and feasible. Conclusion The delivery of a co-designed telehealth-delivered stress mitigation intervention to support people with a road traffic musculoskeletal injury was feasible to deliver and acceptable to people who were at risk of a poor outcome. Further research to evaluate the efficacy of the intervention on outcomes such as pain, self-efficacy, and claims costs are needed.

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Implementation of a novel stratified PAthway of CarE for common musculoskeletal (MSK) conditions in primary care: protocol for a multicentre pragmatic randomised controlled trial (the PACE MSK trial)

Cited by 4 publications

References 67 publications

Patient acceptance of care of a novel care pathway for those at risk of poor outcomes from musculoskeletal pain: A mixed methods study

Patient acceptance of care of a novel care pathway for those at risk of poor outcomes from musculoskeletal pain: A mixed methods study

“Knowing how to play the game”: Clinician experiences of treating patients with a compensable injury in Australia

Evaluation of the acceptability and feasibility of stress mitigation education and support delivered via telehealth for people after road traffic musculoskeletal/orthopaedic injury

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