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NCT Number: NCT07802951

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

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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Key information

Conditions

Collaborative Clinical Reasoning Back Pain Low Back Pain Neurologic Manifestations Pain Pathological Conditions, Signs and Symptoms Signs and Symptoms

Age range

18 year–100 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

A. General Practitioners

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

B. Physiotherapists

  • Be a physiotherapist.
  • Practice physiotherapy in French-speaking Belgium.
  • Practice physiotherapy in primary care.

C. Patients with low back pain

  • Age ≥18 years.
  • 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).
  • Have consulted both a general practitioner and a physiotherapist for this condition in primary care in French-speaking Belgium.

Exclusion criteria

A. General Practitioners

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

B. Physiotherapists

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

C. Patients with low back pain

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

Treatment and study plan

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.

Primary outcomes

  1. Participants' representations and definitions of Collaborative Clinical Reasoning, identified through reflexive thematic analysis.

    Time frame: 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

  1. Enactment of Collaborative Clinical Reasoning in primary care practice, identified through reflexive thematic analysis.

    Time frame: 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.

  2. Barriers and facilitators to the enactment of Collaborative Clinical Reasoning in primary care practice, identified through reflexive thematic analysis.

    Time frame: 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.

Study contacts

Contact information is provided by the study sponsor or research team.

Franck Verschuren, MD, PhD

CONTACT

[email protected]

+32486120571

Olivier Hunin, PT, Msc

CONTACT

[email protected]

+32478836693

Sponsors and collaborators

Lead sponsor

Université Catholique de Louvain

Other

Registry information

Important dates

Study start
2026
Primary completion
2027
Study completion
2027
First posted
Sep 3, 2026
Registry last updated
Sep 10, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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