Poster Presentation Sydney Spinal Symposium 2025

Evaluating the effect of financial incentives to general practitioners (GPs) on recruitment of people with low back pain with limited English proficiency: Study within a trial (SWAT) protocol.  (#7)

Lisa Vizza 1 2 3 , Christopher G Maher 2 , Rowena Ivers 4 , Andrew McLachlan 1 , Fiona Blyth 1 , Philip James Clare 1 , Rachel Thompson 1 , Louisa Degenhardt 5 , Sharon Reid 1 , Bradley C Martin 6 , Michael Wright 7 , Rawa Osman 8 , Simon D French 9 , Kirsten McCaffery 1 , Gabrielle Campbell 10 , Hazel Jenkins 9 , Stephanie Mathieson 1 , Monika Boogs 11 , Jarrod McMaugh 12 , Carol Bennett 13 14 15 , Fiona Stanaway 1 16 , Christina Abdel Shaheed 1 2 16
  1. The University of Sydney, Camperdown, NSW, Australia
  2. Institute For Musculoskeletal Health, The University of Sydney, Camperdown, NSW, Australia
  3. Charles Perkins Institute, The University of Sydney, Camperdown, NSW, Australia
  4. Graduate School of Medicine, University of Wollongong, Wollongong, NSW, Australia
  5. National Drug and Alcohol Research Centre (NDARC), University of New South Wales, Sydney, NSW, Australia
  6. Division of Pharmaceutical Evaluation and Policy, University of Arkansas for Medical Sciences College of Pharmacy, Little Rock, AR, USA
  7. Centre for Health Economics Research Evaluation, University of Technology , Sydney, NSW, Australia
  8. Quality Use of Medicines (QUM) Connect, Sydney, NSW, Australia
  9. Department of Chiropractic, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
  10. School of Psychology, University of Queensland, sunshine state, Australia
  11. PainAustralia consumer advisory group, Canberra, ACT, Australia
  12. Pharmaceutical Society of Australia, Canberra, ACT, Australia
  13. College of arts and social sciences, The Australian National University, Canberra, ACT, Australia
  14. Department of Health, Therapeutic Goods Administration National Medicines Scheduling Advisory Committee, Canberra, ACT, Australia
  15. Faculty of Health and Science, University of Canberra, Canberra, ACT, Australia
  16. School of Public Health, The University of Sydney, Camperdown, NSW, Australia

AIMS:

There are several barriers to recruiting participants with limited English proficiency into clinical trials, with time constraints being a key barrier.  This may cause a low representation of this group in clinical trials, where 1 out of 5 participants are excluded in low back pain trials due to limited English Proficiency. The study within a trial (SWAT) will determine whether providing additional monetary reimbursement to study GPs increases recruitment of patients with limited English proficiency (English understanding ‘not well’ or ‘not well at all’) who speak Arabic, Cantonese, Mandarin or Italian into the main COMFORT trial (Clinical Observation Management and Function Of low back pain Relief Therapies- ACTRN12622001505796).

METHODS:

COMFORT is a cluster randomised controlled trial in general practice. Forty general practices will be randomised in a 1:1 ratio to either i) intervention (educational outreach visits to support GPs to provide opioid stewardship for their patients with low back pain with non-drug strategies including heat wraps and patient education about judicious opioid use) or ii) control (usual care). In the embedded SWAT, the randomisation schedule will also randomly allocate general practices 1:1 to either a) SWAT intervention (additional monetary reimbursement aimed at enhancing recruitment of individuals with limited English proficiency) or b) SWAT control (no additional reimbursement). Study materials are translated to allow the inclusion of people with limited English proficiency. The SWAT primary outcome will be the proportion of participants with limited English proficiency enrolled into the COMFORT trial in the SWAT intervention versus SWAT control. All other aspects of the SWAT (i.e. recruitment, data collection) will follow COMFORT methodology.

CONCLUSION:

This SWAT will ascertain whether additional monetary reimbursement is a suitable method of facilitating greater recruitment of people with limited English proficiency by GPs participating in the COMFORT clinical trial.