Protocol: Effects of virtual fractuRE Clinic care compared with In-person fracture clinic care on physical function in people with simple fractures: a non-inferiority randomised TriAL (RECITAL)
Min Jiat Teng1,2,3, Adrian Traeger2,3, Tessa Copp4, Kristen Pickles4, Chris Maher2,3 1RPA Virtual Hospital, Sydney Local Health District, NSW Health, Camperdown, NSW, Australia2The University of Sydney, Sydney Musculoskeletal Health, Camperdown, NSW, Australia3Institute for Musculoskeletal Health, Sydney Local Health District, NSW Health, Camperdown, NSW, Australia4Sydney Health Literacy Lab, The University of Sydney, Camperdown, NSW, Australia
Abstract
Orthopaedic clinics were the most frequented medical specialty clinic in 2019-20 and account for 9% of all medical consultation clinics in Australia. Patients can wait up to three hours to be seen at a clinic, leading them to miss out on school or work. RPA Virtual Hospital’s virtual fracture clinic launched in October 2020 to provide follow-up care for patients with simple fractures. The service has seen over 700 patients with anecdotal reports of good patient-reported experiences. However, there is currently no systematic evaluation of the comparative effectiveness of the clinic versus in-person care. RECITAL is a prospective two-arm, parallel group randomised controlled trial, using a non-inferiority design; with nested economic and process evaluations including qualitative interviews with patients and providers. Patients with simple fractures will be randomised to receive their follow-up care either at the virtual (intervention) or in-person orthopaedic (control) clinic. The intervention group will have video consults with a physiotherapist while the control group will have consults with a doctor at the in-person orthopaedic clinic. The primary outcome is physical function at 12 weeks follow-up, measured using the Patient-Specific Functional Scale. Secondary outcomes include pain (Numerical Rating Scale), generic patient-reported health-related quality of life (EQ-5D-5L), patient-reported experience (Generic Short Patient Experiences Questionnaire), cost-effectiveness and adverse outcomes at 6 and 12 weeks. Patients in the virtual group will be invited for a qualitative interview to explore their experiences with virtual care. This study will be submitted for Ethics approval and prospectively registered prior to commencing this year.
Biography
Min Jiat is a physiotherapist who established and is leading the Virtual Fracture Clinic and Virtual Low Back Pain Program at RPA Virtual Hospital. His career goal is to establish sustainable, effective and equitable health services for people with musculoskeletal conditions by developing a system to integrate high-quality research into health services as part of usual care. As a Sydney Research Scholarship recipient, he is a part-time PhD Candidate at the Institute for Musculoskeletal Health. He will be leading a randomised controlled trial with economic and a nested process evaluation to evaluate a virtual clinic for people with simple fractures.