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

Using an internet intervention to support self-management of low back pain in primary care: findings from a randomised controlled feasibility trial (SupportBack)
Using an internet intervention to support self-management of low back pain in primary care: findings from a randomised controlled feasibility trial (SupportBack)
Objective: to determine the feasibility of a randomised controlled trial of an internet intervention for low back pain (LBP) using 3 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, 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 to the stand-alone internet intervention. Trial physiotherapists adhered to the support protocol. Overall follow-up rate on key clinical outcomes at three 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: ISRCTN 31034004
2044-6055
1-14
Geraghty, Adam
2c6549fe-9868-4806-b65a-21881c1930af
Stanford, Rosie
0715bcfe-454a-4caa-a1d8-6973a5576017
Stuart, Beth
626862fc-892b-4f6d-9cbb-7a8d7172b209
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Roberts, Lisa
0a937943-5246-4877-bd6b-4dcd172b5cd0
Foster, Nadine
dcad6e4e-ec6e-4e96-876d-97bce5ec5988
Hill, Jonathan
93c06d5e-66a4-48f9-be26-3ea5812b38d0
Hay, Elaine
9fdd04be-2a91-4b9c-8524-37a6111fdf9c
Turner, David
5c847aef-7d62-4c60-a1b2-ca4c1b856f4a
Malakan, Wandsida
dcc0b52f-2c5a-4c62-b136-40494d5870b7
Leigh, Linda
9048b6fa-9d09-4494-b354-1edb2b7eec12
Yardley, Lucy
64be42c4-511d-484d-abaa-f8813452a22e
Geraghty, Adam
2c6549fe-9868-4806-b65a-21881c1930af
Stanford, Rosie
0715bcfe-454a-4caa-a1d8-6973a5576017
Stuart, Beth
626862fc-892b-4f6d-9cbb-7a8d7172b209
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Roberts, Lisa
0a937943-5246-4877-bd6b-4dcd172b5cd0
Foster, Nadine
dcad6e4e-ec6e-4e96-876d-97bce5ec5988
Hill, Jonathan
93c06d5e-66a4-48f9-be26-3ea5812b38d0
Hay, Elaine
9fdd04be-2a91-4b9c-8524-37a6111fdf9c
Turner, David
5c847aef-7d62-4c60-a1b2-ca4c1b856f4a
Malakan, Wandsida
dcc0b52f-2c5a-4c62-b136-40494d5870b7
Leigh, Linda
9048b6fa-9d09-4494-b354-1edb2b7eec12
Yardley, Lucy
64be42c4-511d-484d-abaa-f8813452a22e

Geraghty, Adam, Stanford, Rosie, Stuart, Beth, Little, Paul, Roberts, Lisa, Foster, Nadine, Hill, Jonathan, Hay, Elaine, Turner, David, Malakan, Wandsida, Leigh, Linda and Yardley, Lucy (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), 1-14. (doi:10.1136/bmjopen-2017-016768).

Record type: Article

Abstract

Objective: to determine the feasibility of a randomised controlled trial of an internet intervention for low back pain (LBP) using 3 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, 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 to the stand-alone internet intervention. Trial physiotherapists adhered to the support protocol. Overall follow-up rate on key clinical outcomes at three 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: ISRCTN 31034004

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More information

Accepted/In Press date: 16 January 2018
e-pub ahead of print date: 9 March 2018
Published date: March 2018

Identifiers

Local EPrints ID: 417150
URI: https://eprints.soton.ac.uk/id/eprint/417150
ISSN: 2044-6055
PURE UUID: d270fa75-07e9-42e4-9317-aa7a3d5d2ef0

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Date deposited: 22 Jan 2018 17:30
Last modified: 17 May 2018 04:01

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Contributors

Author: Adam Geraghty
Author: Rosie Stanford
Author: Beth Stuart
Author: Paul Little
Author: Lisa Roberts
Author: Nadine Foster
Author: Jonathan Hill
Author: Elaine Hay
Author: David Turner
Author: Wandsida Malakan
Author: Linda Leigh
Author: Lucy Yardley

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