Shoulder Pain: PANDA-S

Original video: https://youtu.be/w5yZd-rzrC4

Shoulder pain is common, accounting for 1.5 million consultations in general practice each year. Many patients recover quickly, but forty percent will still be reporting pain and disability at six to twelve months after first presenting with their shoulder pain to their GP, extended scope nurse, or first contact practitioner.

The PANDAS cohort study aims to investigate the short and long-term outcomes of shoulder pain. We plan to develop a prediction tool that can help identify which people are likely to recover and can self-manage their shoulder problem, but also those who are at an increased risk of long-term shoulder pain and disability and can benefit from further treatment.

If people with shoulder pain agree to take part in the PANDAS study, they are asked to complete questionnaires, which can be sent by post or done online. Questionnaires are sent after their first consultation, after 3, 6, and 12 months, and after two and three years. They can be completed at home and take around 15 to 30 minutes.

There are additional components to the PANDAS study that all participants are invited to take part in; however, these are all optional. They include short-term data collection using a smartphone app or text messaging service. This is so we can investigate who responds quickly to treatment. We are also interviewing a small number of participants by telephone to better understand their thoughts, beliefs, and concerns regarding the diagnosis and treatment of their shoulder pain. Finally, where possible, we invite participants to attend a PANDAS research clinic, where they receive an examination and an ultrasound scan of their shoulder.

To do this, we asked GPs, nurses, and first contact practitioners to help us spot potentially eligible patients during routine consultations.

When you see a patient with shoulder pain, briefly mention the study either in practice or during a remote consultation. Code the consultation, which will trigger a pop-up to remind you of the purpose of the study. The pop-up screen only requires a couple of clicks to ensure the patient is eligible, and you're done. Once a week, the practice will download tagged records and send the list securely to Keele CTU, who will mail out a study pack to potential participants. The patient will receive a PANDAS study pack, which includes information about the study and the first questionnaire. They can then decide whether or not to take part in the study from the comfort of their own home. If they complete and return the questionnaire either by post or online, they confirm their participation in PANDAS.

We're interviewing a number of PANDAS participants with shoulder pain, but we also feel it's really important to understand the opinions of healthcare professionals about the diagnosis and treatment of shoulder pain and their experiences and concerns when making decisions with their patients. We'll be carrying out a small number of interviews, and this means that you may be invited to take part in this qualitative study. The interview will be conducted over the phone and should take no more than 30 minutes.

Thank you so much for listening to this introduction. We do hope you will remember the PANDAS study when you see people with shoulder pain in your practice. Our aim is to include at least 400 participants so that we can generate strong evidence to inform the management of people with shoulder pain. The findings will also allow GPs and physiotherapists to make more informed decisions when choosing between different treatment options, such as exercise or steroid injection, and when deciding to refer for an ultrasound scan or for a specialist opinion. The study will also form the basis of a future trial in which we will test the effectiveness of better-targeted or more personalized care for shoulder pain. So, your help is really appreciated. Thanks very much.