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

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
patients’ 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.

Co- applicant

Hazel Everitt

Amount awarded: £1,163,994