EMPATHICA - Expectation Management for Patients in Primary Care: Developing and Feasibility Testing a New Digital Intervention for Practitioners

This work aims to enable primary care practitioners to enhance the effectiveness of therapies for Osteoarthritis pain through the development of a brief digital intervention: “Expectation Management for Patients with Osteoarthritis” (Empathica).

Osteoarthritis pain is common, costly, and challenging to manage in busy primary care settings. While various drug-based and non-drug-based treatments are recommended, patients still experience pain, poor quality-of-life, and drug side effects. Regardless of which treatment patients receive, excellent practitioner-patient communication can significantly reduce patients’ pain while improving quality of life and satisfaction with care. We recently showed that patients experience less pain after consulting practitioners who show empathy and encourage optimism about treatment. Yet practitioners vary widely in how much they show empathy. We plan to develop an online training package to teach practitioners (GPs, physiotherapists, and nurses) how to show more empathy and encourage patients to have positive yet realistic expectations.

Our research questions are:

What strategies should we teach practitioners to use so that they will show more empathy and encourage patients to have realistic and positive expectations?
What are patients’ and practitioners’ concerns and priorities, to address in our training?
How can we make our training engaging and relevant for practitioners so that they use it?

To answer these questions, we will:

Review existing trials to confirm what strategies enhance practitioner engagement.
Review existing qualitative studies to identify patients’ and practitioners’ priorities and concerns.
Interview practitioners so we can make our training engaging and persuasive.

To design our training, we will make a plan and use published evidence about how to help people change their behaviour. To produce our training package, we will test prototypes with patients and practitioners and make improvements. Finally, we will conduct a small ‘feasibility’ trial (named the ‘Talking in Primary Care (TIP) study’) to help us design a large, fundable, clinical trial. If successful, our training package should enable practitioners to improve the long-term effectiveness of all drug and non-drug therapies for osteoarthritis pain, reduce patients’ pain and improve quality of life.

The TIP study will help us understand patients’ experiences of appointments with healthcare professionals from their GP practice. Due to the COVID-19 pandemic, the study has been adapted to fit in with the current practice of remote GP consultations:

The two parts of the TIP study are:
1. Healthcare professionals undertake the online training and provide interview feedback on their experience.
2. Patients who have recently had an appointment at their GP surgery (either face-to-face or remotely) are invited to complete a 2-part online survey about their experiences of the appointment and their general health and wellbeing. Some of these participants will be invited to take part in a telephone interview to give more information about the appointment and their experience of completing the survey.

Due to the changes required due to the pandemic, we are now able to recruit more patients to the study and gain valuable knowledge on how empathy and optimism differ in both remote and face-to-face appointments.