Abstract
BackgroundThe Clinical Guideline for the Diagnosis and Management of Work-related Mental Health Conditions in General Practice (the Guideline) was published in 2019. The objective of this trial is to implement the Guideline in general practice.Trial designImplementing work-related Mental health conditions in general PRacticE is a hybrid III, parallel cluster randomised controlled trial undertaken in Australia. Its primary aim is to assess the effectiveness of a complex intervention on the implementation of the Guideline in general practice. Secondary aims are to assess patient health and work outcomes, to evaluate the cost-effectiveness of the trial, and to develop a plan for sustainability.MethodsA total of 86 GP clusters will be randomly allocated either to the intervention arm, where they will receive a complex intervention comprising academic detailing, enrolment in a community of practice and resources, or to the control arm, where they will not receive the intervention. GP guideline concordance will be assessed at baseline and 9 months using virtual simulated patient scenarios. Patients who meet the eligibility criteria (>18years, employed, and receiving care from a participating GP for a suspected or confirmed work-related mental health condition) will be invited to complete surveys about their health and work participation and provide access to their health service use data. Data on health service use and work participation compensation claim data will be combined with measures of guideline concordance and patient outcomes to inform an economic evaluation. A realist evaluation will be conducted to inform the development of a plan for sustainability.ResultsWe anticipate that GPs who receive the intervention will have higher guideline concordance than GPs in the control group. We also anticipate that higher concordance will translate to better health and return-to-work outcomes for patients, as well as cost-savings to society.ConclusionsThe trial builds on a body of work defining the role of GPs in compensable injury, exploring their concerns, and developing evidence-based guidelines to address them. Implementation of these guidelines has the potential to deliver improvements in GP care, patient health, and return-to-work outcomes.Trial registrationACTRN12620001163998, November 2020
Highlights
The Clinical Guideline for the Diagnosis and Management of Work-related Mental Health Conditions in General Practice was published in 2019
The trial builds on a body of work defining the role of General practitioner (GP) in compensable injury, exploring their concerns, and developing evidence-based guidelines to address them
This study aims to assess the effectiveness of a complex intervention involving academic detailing, provision of resources, and engagement in a digital community of practice on the implementation of evidence-based guidelines for the diagnosis and management of work-related mental health conditions in general practice
Summary
The Clinical Guideline for the Diagnosis and Management of Work-related Mental Health Conditions in General Practice (the Guideline) was published in 2019. That similar challenges are described internationally underscores that across the compensable injury landscape, patients with mental health conditions that have arisen from work are seen as difficult to manage, and that GPs are fundamental to brokering improved health and employment outcomes for such patients. The nature of these challenges suggests that they can be overcome through interventions that improve knowledge and offer GPs the opportunity to grow their confidence and skills in providing care
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