Skip to main content
Research project

Talking in Primary Care 2 (TIP2)

Project overview

This research aims to build on the feasibility work conducted in the Empathica study (Empathica | Medicine | University of Southampton) 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.

Study Team:
Co-Lead Investigators: Prof Felicity Bishop and Prof Hazel Everitt
Co-investigators: 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 Howick, Dr Helen Atherton.
PPI co-applicant: Mrs Jennifer Bostock.


Lead researcher

Professor Hazel Everitt

Professor of Primary Care Research

Research interests

  • Supporting Self-management 
  • Healthcare communication
  • Development of digital interventions
Other researchers

Professor Paul Little

Professor in Primary Care Research

Dr Don Cruickshank

Research Software Engineer

Professor Flis Bishop

Professor of Health Psychology

Research interests

  • Placebo effects and context effects in healthcare
  • Complementary and integrative medicine utilisation
  • Treatment decision-making and adherence

Professor Geraldine Leydon

Prof of Medicine, Sociology & Healthcare

Research interests

  • Healthcare communication
  • Qualitative methods in health reesarch 
  • Optimising the patient experience

Dr Leanne Morrison

Associate Professor

Research interests

  • Health Psychology 
  • Person-based intervention development 
  • Digital technology 

Dr Jane Vennik

Senior Research Fellow

Collaborating research institutes, centres and groups

to top