Supporting self-management of low back pain with an internet intervention in primary care: A randomised controlled trial of clinical and cost-effectiveness (SupportBack 2).

Conference:

SAPC ASM 2018 - London

Talk Code:

P2.90

Presenter:

Adam W A Geraghty

Co-authors:

Nadine E Foster, Jonathan C Hill, Lucy Yardley, Lisa C Roberts, Beth Stuart, Elaine M Hay, David Turner, Linda Leigh, Gareth Griffiths, Paul Little

Author institutions:

University of Southampton. Keele University, University of Bristol, University of East Anglia.

Problem

Low back pain (LBP) is a highly prevalent symptom and a leading cause of disability globally. The majority of patients with LBP will present to primary care, where NICE guidelines recommend provision of advice to self-manage and stay active as a first-line care strategy. However, rapid support for behavioural self-management is often severely limited or absent, with variable wait-times serving as a barrier to physiotherapy.

Approach

‘SupportBack’ is an internet intervention that has been developed specifically for primary care patients presenting with LBP. A recent study demonstrated the feasibility of a randomised controlled trial (RCT) in primary care, as well as the acceptability of the interventions delivered as stand-alone, or with brief telephone physiotherapy support (Geraghty et al. 2018). The aim of the SupportBack 2 multicentre randomised controlled trial (RCT) is to determine the clinical and cost-effectiveness of the SupportBack interventions in reducing LBP-related physical disability in primary care patients over 12 months. The RCT will examine 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 will be the Roland Morris Disability Questionnaire (RMDQ) measured at 6 weeks, 3, 6 and 12 months.

Findings

The trial is currently in setup and will report in 2021.

Consequences

To our knowledge, the SupportBack 2 RCT will be the first full trial of its kind in LBP within UK primary care. The trial will extend knowledge regarding the application of internet interventions in a pragmatic context, as well increasing understanding of the effects of integration of remote telephone specialist support. In addition to determining clinical and cost-effectiveness, the trial is designed to substantially advance the understanding of how self-management interventions affect change in pain and LBP-related disability through a mixed-methods process evaluation.

Submitted by:

Adam Geraghty

Funding acknowledgement:

This project was funded by the NIHR Health Technology Assessment (HTA) programme (project number 16/111/78). The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health.