General practitioners apply the usual care for shoulder complaints better than expected--analysis of videotaped consultations.
BACKGROUND
The education and activation program (EAP) is a newly developed intervention to prevent the development of chronic shoulder complaints (SCs). Trained general practitioners (GPs) administer the EAP. The EAP addresses inadequate cognitions and maladaptive behavior related to the SCs. The effect of the EAP is evaluated in a randomized clinical trial. The aim of the present study is to use videotaped consultations to study (1) the performance of trained GPs administering the EAP and (2) the presence of key features of the EAP already embedded in usual care (UC).


METHODS
Five trained GPs were videotaped while treating a standardized patient with EAP. Additionally, five GPs administering UC were videotaped. Two blinded observers evaluated the videotapes in relation to key features of the EAP which were scored on the EAP checklist.


RESULTS
The mean total score on the EAP checklist was 4.7 (SD = 2.9) for the UC group and 7.1 (SD = 2.1) for the EAP group. Neither group reached a score higher than 8, which was considered to reflect an acceptable number of key EAP features.


CONCLUSIONS
Our comparison of the presence of key features of EAP shows that the UC and EAP groups differed less than was expected. GPs in the UC group performed above expectation, with a mean total score of 4.7. Moreover, the low number of key features present in the EAP group may very well have led to a reduced effectiveness of the EAP. The results of this study can be used to optimize the training of GPs using the EAP.
De Bruijn
Camiel
C
Institute for Rehabilitation Research, Hoensbroek, The Netherlands. camieldebruijn@hetnet.nl
de Bie
Rob
R
Geraets
Jacques
J
Goossens
Marielle
M
Köke
Albère
A
van den Heuvel
Wim
W
Dinant
Geert-Jan
GJ
D000328:Adult; D000700:Analgesics / Q000627:therapeutic use; D001291:Attitude of Health Personnel; D002908:Chronic Disease; D002983:Clinical Competence; D004502:Education, Medical, Continuing / Q000379:methods*; D005194:Family Practice / Q000193:education* / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D009426:Netherlands; D010147:Pain Measurement; D026741:Physical Therapy Modalities; D011336:Probability; D011787:Quality of Health Care; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D020069:Shoulder Pain / Q000175:diagnosis / Q000628:therapy*; D016896:Treatment Outcome; D014743:Videotape Recording
D000700:Analgesics