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Trial registered on ANZCTR
Registration number
ACTRN12623000603617
Ethics application status
Approved
Date submitted
24/05/2023
Date registered
2/06/2023
Date last updated
29/02/2024
Date data sharing statement initially provided
2/06/2023
Type of registration
Prospectively registered
Titles & IDs
Public title
Back pain fact sheets and decisions about future healthcare
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Scientific title
Effect of back pain fact sheets on decisions about future healthcare in adults attending primary care
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Secondary ID [1]
309731
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None
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
low back pain
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Condition category
Condition code
Musculoskeletal
327003
327003
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0
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Other muscular and skeletal disorders
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Public Health
327056
327056
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0
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Health promotion/education
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
JAMA Patient Page on low back pain. 1 page fact sheet delivered by GP or by SMS from GP practice. Content focuses on listing evidence-based treatment options. Freely available resource accessible at: https://jamanetwork.com/journals/jama/fullarticle/2782184
Participants can read the fact sheet at their own time and pace. GPs can open and discuss the fact sheet with their patient during the consult if they wish. Twenty-four hours after their consultation with the GP, HealthShare sends patients an SMS containing a link to the fact sheet on behalf of the GP. To monitor adherence participants will complete a study-specific questionnaire.
Participants can also access the fact sheet via an advertisement on social media (Facebook, Twitter, and Instagram). The advertisement will invite people with experience of back pain to view a fact sheet and complete a short survey.
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Intervention code [1]
326171
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Treatment: Other
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Comparator / control treatment
Australian Commission for Healthcare Safety and Quality Information for Patients Fact Sheet (ACHSQ fact sheet), 1 page fact sheet delivered by GP or by SMS from GP practice. Content focuses on explaining how a person can self-manage back pain. Freely available resource accessible at: https://www.safetyandquality.gov.au/publications-and resources/resource-library/how-manage-your-low-back-pain-information-patients
Participants can read the fact sheet at their own time and pace. GPs can open and discuss the fact sheet with their patient during the consult if they wish. Twenty-four hours after their consultation with the GP, HealthShare sends patients an SMS containing a link to the fact sheet on behalf of the GP. To monitor adherence participants will complete a study-specific questionnaire.
Participants can also access the fact sheet via an advertisement on social media (Facebook, Twitter, and Instagram). The advertisement will invite people with experience of back pain to view a fact sheet and complete a short survey.
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Control group
Active
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Outcomes
Primary outcome [1]
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Preparation for decision-making, measured using the Preparation for Decision Making (PrepDM) scale.
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Assessment method [1]
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Timepoint [1]
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Immediate (after reading fact sheet)
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Secondary outcome [1]
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Management intentions assessed by study-specific questionnaire
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Assessment method [1]
422273
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Timepoint [1]
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Immediate (after reading fact sheet)
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Secondary outcome [2]
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Reassurance assessed by study-specific questionnaire
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Assessment method [2]
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Timepoint [2]
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Immediate (after reading fact sheet)
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Secondary outcome [3]
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Acceptability assessed by study-specific questionnaire
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Assessment method [3]
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Timepoint [3]
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Immediate (after reading fact sheet)
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Secondary outcome [4]
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Fidelity assessed by study-specific questionnaire
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Assessment method [4]
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Timepoint [4]
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Immediate (after reading fact sheet)
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Eligibility
Key inclusion criteria
1. People 18 years or older
2. Visiting their GP for back pain
3. Receive a back pain fact sheet and choose to complete the online survey
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Nil
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Study design
Purpose of the study
Educational / counselling / training
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Allocation is not concealed
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
This study is quasi randomised. Participants are allocated to intervention and control groups via three methods. The first method is based on GP discretion as to which study fact sheet they provide to their patient. The comparison of outcomes for people allocated to fact sheet interventions via this method is therefore non-random. The second allocation method is random. Based on a computerised random number list, a GP software provider will allocate access to either the intervention or control fact sheet, for one month at a time for the duration of the trial. The comparison of outcomes for people allocated to interventions via this method is therefore based on a randomised computer generated sequence.
The third allocation method will be random. Participants via social media advertisement will be allocated to either intervention or control fact sheet randomly.
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
Our primary analysis will compare the PrepDM scores in people exposed to the JAMA fact sheet vs the ACHSQ fact sheet, immediately after they have read the sheet. Assuming a mean difference of 6 points on a 100-point scale (ie 60 points in JAMA fact sheet group, 54 points in ACHSQ group, SD of 26) with 90% power, we require a sample size of 790. To account for anticipated uneven group size we will increase the minimum sample size to 1000.
For the secondary outcomes of management intentions, reassurance, and acceptability, we compare means and proportions where applicable in the whole sample and generate 95% confidence intervals.
Subgroup analysis
We will compare the effects of the sheets on PrepDM scores in people with chronic pain vs acute pain, and in people with higher pain intensity vs lower pain intensity. We will also examine effects on healthcare intentions in people who received the fact sheet through GP-led approach vs patient-led approach, and people who had seen their GP in the past 4 weeks vs those who had not.
Data from patients receiving a fact sheet using random and non-random methods of allocation will be analysed separately in a sensitivity analysis.
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
2/06/2023
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Actual
2/06/2023
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Date of last participant enrolment
Anticipated
7/06/2024
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Actual
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Date of last data collection
Anticipated
7/06/2024
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Actual
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Sample size
Target
1000
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Accrual to date
474
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Final
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Recruitment in Australia
Recruitment state(s)
ACT,NSW,NT,QLD,SA,TAS,WA,VIC
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Funding & Sponsors
Funding source category [1]
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University
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Name [1]
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The University of Sydney, Faculty of Medicine and Health (Next Step Funding)
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Address [1]
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The University of Sydney
NSW 2006
Australia
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Country [1]
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Australia
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Primary sponsor type
University
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Name
The University of Sydney
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Address
The University of Sydney
NSW 2006
Australia
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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N/A
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Address [1]
315781
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N/A
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Country [1]
315781
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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The University of Sydney Human Research Ethics Committee
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Ethics committee address [1]
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The University of Sydney NSW 2006 Australia
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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Approval date [1]
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22/05/2023
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Ethics approval number [1]
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2023/179
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Summary
Brief summary
There is no rigorous evidence on the effects of back pain fact sheets among people seeking care for low back pain from their general practitioner. It is uncertain whether a fact sheet resource that focuses more on listing medical management options (JAMA Patient Page- low back pain), can increase a patient’s preparedness for decision-making, compared with a resource that focuses on self-management (Australian Commission for Healthcare Safety and Quality Information for Patients Fact Sheet). Our primary aim is to compare preparation for decision-making among people seeking care for low back pain who are given one of two currently available fact sheets. Secondary aims are to understand recruitment processes and engagement with research fact sheets, examine management intentions, feelings of reassurance about serious pathology and the acceptability of the fact sheets to people seeking care for low back pain. The study hypothesis is that a fact sheet resource which focuses more on listing medical management options (JAMA Patient Page- low back pain), can increase a patient’s preparedness for decision-making more than a fact sheet that focuses on self-management (Australian Commission for Healthcare Safety and Quality Information for Patients Fact Sheet).
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Adrian Traeger
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Address
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The University of Sydney
Level 10N, King George V Building, Royal Prince Alfred Hospital (C39)
PO Box M179, Missenden Road, NSW, 2050
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Country
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Australia
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Phone
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+61286276231
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Adrian Traeger
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Address
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The University of Sydney
Level 10N, King George V Building, Royal Prince Alfred Hospital (C39)
PO Box M179, Missenden Road, NSW, 2050
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Country
126875
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Australia
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Phone
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+61286276231
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Fax
126875
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Email
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[email protected]
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Contact person for scientific queries
Name
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Adrian Traeger
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Address
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The University of Sydney
Level 10N, King George V Building, Royal Prince Alfred Hospital (C39)
PO Box M179, Missenden Road, NSW, 2050
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Country
126876
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Australia
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Phone
126876
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+61286276231
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Fax
126876
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Email
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
IPD will not be available
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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