IHO044

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Synopsis

Each year >100,000 Australians experience a road traffic injury––the majority (75%) are considered non-catastrophic musculoskeletal injuries (nRTIs). Up to 50% of cases do not recover but develop chronic pain (pain that persists =3 months). This represents a significant health burden for Australia. A biopsychosocial approach to care is recommended and our RCT showed that when physiotherapists include psychological strategies as part of their treatment (StressModex RCT), recovery improves. However, this approach is not in routine use in Australia with a major barrier being limited training and lack confidence of physiotherapists to deliver psychological care. Under RCT conditions, we showed that 2-day in-person training improved patient outcomes. In-person training is difficult to scale limiting widespread implementation and sustainable change in clinical practice. To address this barrier, together with our partners, we have developed a novel on-line implementation strategy (PICOT: Physiotherapists bIopsyChosocial On-line Training) to implement the StressModex intervention. Our VISION is that all physiotherapists, nationwide, deliver effective early biopsychosocial care to improve health outcomes for people with nRTI. We will conduct a hybrid implementation-effectiveness cluster randomised controlled trial in primary care physiotherapy practices. The aims of this research are to: (1) Compare the effectiveness of the two implementation strategies (in-person training versus PICOT) on the delivery of StressModex in routine physiotherapy practice; (2) Compare the effectiveness of the two implementation strategies on patient outcomes; and (3) Compare the cost-effectiveness of the two implementation strategies. A process evaluation will inform broad scale-up beyond this RCT. Consumers and end-users (clinicians, policy makers) have been involved in the development and piloting of our implementation strategy and they will continue to play a central role in this trial.