Clinicians' perspectives on planned interventions tested in the Otago MASTER feasibility trial: an...

Area of Science:

• Orthopedics
• Physical Therapy
• Clinical Trials

Background:

• Subacromial shoulder pain is a common musculoskeletal condition.
• The Otago MASTER (MAnagement of Subacromial disorders of The shouldER) trial aimed to assess the feasibility of a new intervention.
• Process evaluations are crucial for understanding intervention delivery in clinical trials.

Purpose of the Study:

• To evaluate the treatment fidelity of supervised interventions in the Otago MASTER feasibility trial.
• To explore clinicians' perceptions of the trial interventions and identify implementation barriers.

Main Methods:

• A mixed-methods process evaluation was conducted in parallel with the Otago MASTER feasibility trial.
• Treatment fidelity was assessed via record audits.
• Clinicians' perceptions were gathered through a focus group, analyzed thematically.

Main Results:

• Treatment fidelity scores were 80.3% for tailored exercise/manual therapy and 82.9% for standardized exercise.
• Clinicians reported conflicts between their individual practice and the intervention protocol.
• Identified barriers included program strengths/weaknesses, design/administrative issues, and training limitations.

Conclusions:

• Supervised treatment fidelity in the Otago MASTER feasibility trial was generally acceptable.
• Clinicians encountered barriers that need addressing for future trial implementation.
• Findings inform the design of the definitive trial and future feasibility studies.