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The University of Southampton
Medicine

Research project: Talking in Primary Care 2: Testing the effects of communication skills e-learning for practitioners on patients’ musculoskeletal pain and enablement (TIP2)

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This research aims to build on the feasibility work conducted in the Empathica study to determine the effectiveness and cost-effectiveness of the EMPathicO training for PCPs in improving outcomes for patients presenting with MSK pain in primary care.

Musculoskeletal (MSK) pain is a big problem for patients and as the population ages it is set to become an even bigger one. Osteoarthritis is a leading cause of MSK pain.  Back pain and neck pain are also very common.  MSK pain is difficult to treat with pain affecting patients’ social life, wellbeing and employment. Many primary care appointments involve patients who have MSK pain and it can be difficult to know how best to help these patients. “Primary care appointments” includes consultations that patients have with GPs, nurses, and some physiotherapists. During COVID-19, primary care appointments have changed to mainly telephone or video rather than face to face and this is likely to continue. Hence the way in which doctors and other clinicians communicate with patients is changing.  

Previous research we conducted shows that it is possible to change the way GPs communicate with patients about MSK pain.  And our reviews of other people’s research show that changing GP communication can actually help reduce pain and improve patient’s quality of life and satisfaction with the GP. This is probably also true for other primary care clinicians like nurses and physiotherapists although research has tended to focus on GPs. Better communication may also increase patients’ confidence to manage their health and reduce the need for further primary care appointments. This is good for patients in that they feel less pain and are more able to manage their condition, good for doctors as they are giving a better service, and good for the NHS as it enables best use of limited primary care appointments. This current study aims to quantify these benefits. 

We will test a communication e-learning training package that we have developed which helps GPs, nurses, and physiotherapists deliver positive empathic care. We will test whether GPs and others can deliver positive empathic care during remote and in-person consultations and we will measure the effects on the patient’s pain, other symptoms, and quality of life.  We will also measure the cost of delivering the training and the economic costs and benefits of doing so. We will do this by comparing primary care practices that have been trained to deliver positive empathic care with practices that have not had our training (we call this a randomised controlled trial). We think positive empathic care might benefit other patients, as well as those who have MSK pain.  Therefore, in our project we will also include patients who have appointments for other symptoms. 

We hope that the evidence we will present will enable the NHS to deliver better care for patients with MSK pain and other symptoms. If shown to be successful, this training could quickly be made available at low cost to primary care practices across the country. 

Lead Investigators: Dr Felicity Bishop, Prof Hazel Everitt

Co-applicants: Prof Paul Little, Prof Geraldine Leydon, Dr Beth Stuart, Dr Leanne Morrison, Dr Jane Vennik, Prof Christian Mallen, Dr Lorna Clarson, Prof Matthew Ridd, Dr Kirsty Garfield, Dr Jeremy Horwick, Dr Helen Atherton.
PPI co-applicant: Mrs Jennifer Bostock

Funder: NIHR School for Primary Care Research (Project 563)

Duration: 1 January 2022 – 30 June 2024

Contact: Prof Hazel Everitt h.a.everitt@soton.ac.ukDr Felicity Bishop F.L.Bishop@soton.ac.uk

This study is being conducted by the Primary Care Research Centre.

Research Theme

Healthcare communication

Content area

Long-term conditions

Related research groups

Primary Care, Population Sciences and Medical Education
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