PANDA-S

Summary

Shoulder problems affect 20% of adults and are often very painful, affecting sleep, work, and everyday life. In England, annually about 1.5 million people visit their GP for shoulder pain, of whom 40% experience on-going pain. Most patients receive treatment from GPs or physiotherapists, but 7 times more patients are having surgery compared with 10 years ago. There is no evidence that surgery provides better results than non-surgical treatments such as shoulder exercises.

Aim: To develop and test a better approach to assessing the likely cause (diagnosis) and future outcome (prognosis) of shoulder problems, so that treatments are offered to those patients who benefit the most. This research will benefit patients and the NHS by: Improving information and advice given to patients about the possible causes of shoulder pain and the best ways to assess and treat shoulder pain. Research plan: Recruit 471 patients consulting their GP or presenting to physiotherapy with shoulder pain to a follow-up study. Their GPs and physiotherapists will continue to treat them in the way they feel is most appropriate. Consenting participants will;

i. Complete 6 questionnaires on pain, difficulties with everyday activities, treatments, and quality of life over 3 years, providing unique information about long-term outcomes
ii. Attend an optional clinical assessment including an ultrasound scan of the shoulder
iii. Complete an optional app or respond to text messages once a week for 12 weeks to provide short term information on shoulder pain and difficulties with everyday activities iv.Participate in an optional interview about their shoulder pain

Study design

This is an observational cohort study and qualitative study.

Aim and objectives

The overall aim of the prospective cohort study is to investigate the short and long-term outcomes of shoulder pain and develop a prediction model using diagnostic and prognostic information to accurately predict 6-month outcomes of shoulder pain and disability. This model will form the basis for the subsequent development of an easy-to-use prognostic stratification and treatment decision tool. The aims of the tool will be to accurately identify patients at low versus increased risk of poor outcome, and support clinicians and patients to make optimal decisions regarding self-management, treatment, and referral.

The overall aim of the qualitative study is to investigate the influences on, and uncertainty regarding, decision making and perspectives on the importance of diagnostic and prognostic information when negotiating treatment and referral options for shoulder pain in primary care.

Publications

Predicting pain and function outcomes in people consulting with shoulder pain: The PANDA-S clinical cohort and qualitative study protocol