Well informed physician-patient communication in consultations on back pain – study protocol of the cluster randomized GAP trial

Abstract

Background Back pain is one of the most frequent causes of health-related work absence. In Germany, more than 70% of adults suffer from at least one back pain episode per annum. It has strong impact on health care costs and patients’ quality of life. Patients increasingly seek health information on the internet. However, judging its trustworthiness is difficult. In addition, physicians who are being confronted with this type of information often experience it to complicate the physician-patient interaction. The GAP trial aims to develop, implement and evaluate an evidence-based, easy-to-understand and trustworthy internet information portal on lower back pain to be used by general practitioners and patients during and after the consultation. Effectiveness of GAP portal use compared to routine consultation on improving communication and informedness of both physicians and patients will be assessed. In addition, effects on health care costs and patients’ days of sick leave will be evaluated. Methods We will conduct a prospective multi-centre, cluster-randomized parallel group trial including 1500 patients and 150 recruiting general practitioners. The intervention group will have access to the GAP portal. The portal will contain brief guides for patients and physicians on how to improve the consultation as well as information on epidemiology, aetiology, symptoms, benefits and harms of treatment options for acute, sub-acute and chronic lower back pain. The GAP portal will be designed to be user-friendly and present information on back pain tailored for either patients or physicians in form of brief fact sheets, educative videos, info-graphics, animations and glossaries. Physicians and patients will assess their informedness and the physician-patient communication in consultations at baseline and at two time points after the consultations under investigation. Days of sick leave and health care costs related to back pain will be compared between control and intervention group using routine data of company health insurance funds. Discussion The GAP-trial intends to improve the communication between physicians and their patients and the informedness of both groups. If proven beneficial, the evidence-based and user-friendly portal will be made accessible for all patients and health professionals in back pain care. Inclusion of further indications might be implemented and evaluated in the long term. Trial registration German Clinical Trials Register DRKS00014279 (registered 27th of April 2018). Electronic supplementary material The online version of this article (10.1186/s12875-019-0925-8) contains supplementary material, which is available to authorized users.

Quality of life and objective functional impairment in lumbar spinal stenosis: a protocol for a systematic review and meta-analysis of moderators

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“…Proposed changes at any stage were incorporated in the coding and the process was repeated until theoretical saturation was reached. 31 thorough examination, 7,13 describing findings, 6,9 describing causes, 7,11 questions asked, 2,8 shared decision making, 3,6 rapport-building, 5,10 trusting relationship, 5,18 facing hospital environment, 7,12 managing frustration/anger, 9,11 While coding the transcript of the thirteenth patient and twelfth doctor, no new insights were found. All of the responses seemed to be repeated to the responses of the previous patients and doctors respectively.…”

“…6 Patients add value in their healthcare by building a positive relationship with the doctors 7,8 and clarifying their disease-specific doubts. 9,10 Researchers also believe that patients follow the process of treatment as suggested by the concerned doctors. 11,12 Doctors provide the necessary details and council the patients as required.…”

Variance components of ratings of physician-patient communication: A generalizability theory analysis

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