Using an internet intervention to support self-management of low back pain in primary care: findings from a randomised controlled feasibility trial (SupportBack).

Geraghty, Adam W A; Stanford, Rosie; Stuart, Beth; Little, Paul; Roberts, Lisa C; Foster, Nadine E; Hill, Jonathan C; Hay, Elaine M; Turner, David; Malakan, Wansida; Leigh, Linda; Yardley, Lucy

Abstract

OBJECTIVE: To determine the feasibility of a randomised controlled trial of an internet intervention for low back pain (LBP) using three arms: (1) usual care, (2) usual care plus an internet intervention or (3) usual care plus an internet intervention with additional physiotherapist telephone support.

DESIGN AND SETTING: A three-armed randomised controlled feasibility trial conducted in 12 general practices in England.

PARTICIPANTS: Primary care patients aged over 18 years, with current LBP, access to the internet and without indicators of serious spinal pathology or systemic illness.

INTERVENTIONS: The 'SupportBack' internet intervention delivers a 6-week, tailored programme, focused on graded goal setting, self-monitoring and provision of tailored feedback to encourage physical activity. Additional physiotherapist telephone support consisted of three brief telephone calls over a 4-week period, to address any concerns and provide reassurance.

OUTCOMES: The primary outcomes were the feasibility of the trial design including recruitment, adherence and retention at follow-up. Secondary descriptive and exploratory analyses were conducted on clinical outcomes including LBP-related disability at 3 months follow-up.

RESULTS: Primary outcomes: 87 patients with LBP were recruited (target 60-90) over 6 months, and there were 3 withdrawals. Adherence to the intervention was higher in the physiotherapist-supported arm, compared with the stand-alone internet intervention. Trial physiotherapists adhered to the support protocol. Overall follow-up rate on key clinical outcomes at 3?months follow-up was 84%.

CONCLUSIONS: This study demonstrated the feasibility of a future definitive randomised controlled trial to determine the clinical and cost-effectiveness of the SupportBack intervention in primary care patients with LBP.

TRIAL REGISTRATION NUMBER: ISRCTN31034004; Results.

Citation

Geraghty, A. W. A., Stanford, R., Stuart, B., Little, P., Roberts, L. C., Foster, N. E., …Yardley, L. (2018). Using an internet intervention to support self-management of low back pain in primary care: findings from a randomised controlled feasibility trial (SupportBack). BMJ Open, 8(3), Article e016768. https://doi.org/10.1136/bmjopen-2017-016768

• Journal Article Type: Article
• Acceptance Date: Jan 16, 2018
• Publication Date: Mar 9, 2018
• Journal: BMJ Open
• Publisher: BMJ Publishing Group
• Peer Reviewed: Peer Reviewed
• Volume: 8
• Issue: 3
• Article Number: e016768
• DOI: https://doi.org/10.1136/bmjopen-2017-016768
• Publisher URL: http://bmjopen.bmj.com/content/8/3/e016768.info