Internet delivered interventions may provide a route to rapid support for behavioural self-management for low back pain (LBP) that could be widely applied within primary care. Although evidence is emerging that more complex technologies (mobile apps linked to digital wristbands) can have some impact on LBP-related disability, there is a need to determine the effectiveness of highly accessible, web-based support for self-management for LBP. We conducted a multi-centre pragmatic randomised controlled trial, testing ‘SupportBack’, an accessible internet intervention developed specifically for primary care. We aimed to determine the effectiveness of the SupportBack interventions in reducing LBP-related physical disability in primary care patients. Participants were randomised to 1 of 3 arms: 1) Usual care + internet intervention + physiotherapy telephone support, 2) Usual care + internet intervention, 3) Usual care alone. Utilising a repeated measures design, the primary outcome for the trial was disability over 12 months using the Roland Morris Disability Questionnaire (RMDQ) at 6 weeks, 3, 6 and 12 months. Results: 826 were randomised, with follow-up rates: 6 weeks = 83%; 3 months = 72%; 6 months = 70%; 12 months = 79%. Analysis is ongoing, comparing each intervention arm versus usual care alone. The key results will be presented at the conference.Background
Methods and results
The EU-funded Back-UP project aims to develop a cloud computer platform to guide the treatment of low back and neck pain (LBNP) in first contact care and early rehabilitation. In order to identify evidence-based treatment options that can be recommended and are accessible to people with LBNP across Europe, we conducted a systematic review of recently published guidelines. Electronic databases, including Medline, Embase, CINAHL, PsycINFO, HMIC, Epistemonikos, PEDro, TRIP, NICE, SIGN, WHO, Guidelines International Network (G-I-N) and DynaMed Plus were searched. We searched for guidelines published by European health professional or guideline development organisations since 2013, focusing on the primary care management of adult patients presenting with back or neck pain (including whiplash associated symptoms, radicular pain, and pregnancy-related LBP). The AGREE-II tool was used to assess the quality of guideline development and reporting.Background and aims
Methods
The STarT Back trial demonstrated that targeting back pain treatment according to patient prognosis (low, medium or high-risk subgroups) is effective. However, the mechanisms leading to these improved treatment outcomes remain unknown. This study aimed to identify which psychological variables included in the study were mediating treatment outcome for all patients and within the low, medium and high-risk subgroups. Secondary analysis was conducted on 466 patients randomised to the active treatment arm with 4-month follow-up available. Psychological variables included depression (HADs), fear (TSK), catastrophising (PCS), bothersomeness and illness perception constructs (IPQ brief) e.g. personal control. Treatment outcome was characterised using change in disability score (RMDQ) at 4-months. Residualised change scores were calculated for each variable and Pearson's correlations were calculated overall and at the subgroup level to determine potential mediating variables for disability improvement.Introduction
Methods
