Collaborative Clinical Reasoning: Perceptions and Practices of General Practitioners, Physical Therapists, and Patients With Low Back Pain in Primary Care

NCT07802951 — Not applicable, Recruiting, 225 participants, Université Catholique de Louvain

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Registry	NCT07802951
Status	Recruiting
Phase	Not applicable
Study type	Interventional; na, single group, masking: none, health services research
Enrollment	225 (Estimated)
Sponsor	Université Catholique de Louvain (Other)
Conditions	Collaborative Clinical Reasoning
Interventions	Focus groups and deliberative workshop (Other)
Dates	start 2026-09-01 (estimated), primary completion 2027-12-01 (estimated), completion 2027-12-01 (estimated), first posted 2026-09-03, last updated 2026-09-10
Locations	1 site in Belgium

-Summary

Low back pain is a major health problem in primary care and is associated with a substantial clinical, economic, and societal burden. Although evidence-based recommendations are available, its management remains heterogeneous, poorly coordinated, and often characterized by overmedicalization. In this context, interprofessional collaboration has been identified as a means of improving primary care but does not necessarily ensure a shared understanding of clinical situations. Collaborative Clinical Reasoning (CCR), defined as the process of developing a shared mental model among healthcare professionals and patient partners, remains insufficiently explored in primary care.

This exploratory qualitative study aims to explore the representations and definitions of Collaborative Clinical Reasoning among general practitioners, physiotherapists, and patient partners with low back pain in French-speaking Belgium. It also aims to examine how CCR is implemented in primary care practice and to identify perceived barriers and facilitators to its implementation.

Data will be collected through separate focus groups involving general practitioners, physiotherapists, and patient partners with low back pain. Qualitative data will be analyzed using inductive reflexive thematic analysis.

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+Arms and interventions

Arm	Type	Interventions	Description
General Practitioners, Physiotherapists, and Patients with non-specific low back	Other	Other: Focus groups and deliberative workshop

Focus groups and deliberative workshop (Other): General practitioners, physiotherapists, and patients will first participate in separate focus groups for each stakeholder group. A subsequent mixed deliberative workshop will bring together participants from the three stakeholder groups to discuss and refine the findings.

+Outcome measures

Primary outcomes

Participants' representations and definitions of Collaborative Clinical Reasoning, identified through reflexive thematic analysis. [From the initial focus groups to the subsequent deliberative workshop, over an estimated 15-month data collection period.]: Participants' representations and definitions of Collaborative Clinical Reasoning will be explored through qualitative data collected during separate focus groups with general practitioners, physiotherapists, and patients with non-specific low back pain, as well as during a subsequent deliberative workshop bringing together these three participant groups.

Secondary outcomes

Enactment of Collaborative Clinical Reasoning in primary care practice, identified through reflexive thematic analysis. [From the initial focus groups to the subsequent deliberative workshop, over an estimated 15-month data collection period.]: The enactment of Collaborative Clinical Reasoning in primary care practice will be explored through qualitative data collected during separate focus groups with general practitioners, physiotherapists, and patients with non-specific low back pain, as well as during a subsequent deliberative workshop bringing together these three participant groups.
Barriers and facilitators to the enactment of Collaborative Clinical Reasoning in primary care practice, identified through reflexive thematic analysis. [From the initial focus groups to the subsequent deliberative workshop, over an estimated 15-month data collection period.]: Barriers and facilitators influencing the enactment of Collaborative Clinical Reasoning in primary care practice will be explored through qualitative data collected during separate focus groups with general practitioners, physiotherapists, and patients with non-specific low back pain, as well as during a subsequent deliberative workshop bringing together these three participant groups.

+Eligibility

Sex: All, ages: 18 Years to 100 Years

Inclusion Criteria:

A. General Practitioners

1. Be a general practitioner or a physician in postgraduate training in general practice.
2. Practice general medicine in French-speaking Belgium.
3. Practice general medicine in primary care.

B. Physiotherapists

1. Be a physiotherapist.
2. Practice physiotherapy in French-speaking Belgium.
3. Practice physiotherapy in primary care.

C. Patients with low back pain

1. Age ≥18 years.
2. Have low back pain (pain between the lower margin of the ribs and the gluteal fold, with or without pain in one or both legs).
3. Have consulted both a general practitioner and a physiotherapist for this condition in primary care in French-speaking Belgium.

Exclusion Criteria:

A. General Practitioners

1\. Be on sick leave during the study (e.g., work incapacity)

B. Physiotherapists

1. Practice exclusively in a nursing home or a nursing home with skilled nursing care.
2. Be on sick leave during the study (e.g., work incapacity).

C. Patients with low back pain

1. Have a known specific lumbar pathology (e.g., fracture, infection, cancer, lumbar radiculopathy, etc).
2. Have a known general condition that may explain the low back pain (e.g., fibromyalgia, osteoporosis, rheumatologic disease, etc).
3. Have undergone back surgery within the past 12 months.
4. Be pregnant or have had a known pregnancy within the past 12 months.
5. Reside in a nursing home or a nursing home with skilled nursing care.

+Locations (1)

Facility	City	Country	Status
UCLouvain - Institute of Health and Society (IRSS)	Woluwe-Saint-Lambert, Brussels Capital	Belgium	Recruiting