PainRelief.com Interview with:
Louise Fleng Sandal PhD
Adjunkt, Institut for Idræt og Biomekanik
SDU University of Southern Denmark
PainRelief.com: What is the background for this study?
Response: Low back pain is a globally prevalent condition with a high economic cost. Many people seek help with primary care from their general practitioner, physiotherapist or chiropractor. Evidence-based guidelines on first line treatment include learning to self-manage, staying active, exercising and learning about the condition. However, many find this difficult without advice and support, but primary care physicians often lack the time and resources to support self-management.
Digital solutions, such as smartphone technology, utilizing artificial intelligence can be used to tailor self-management support to the individual and be available at the individuals convenience.
PainRelief.com: What are the main findings?
Response: In our trial, 461 individuals with low back pain were randomised to either usual care alone or using the selfBACK app as an adjunct to usual care. Those who received the selfBACK intervention had reduced pain-related disability compared to those who only received usual care. The effect was small and the clinical significance maybe uncertain. However, the effect persisted at 9 months follow-up and was seen in the primary outcome and in several of the secondary outcomes. Finally, in the intervention group more patients reached a significant reduction in disability.
PainRelief.com: What should readers take away from your report?
Response: Digital solutions, like the selfBACK app, can provide tailored self-management support to the individual to aid them in their self-management. This trial showed an effect of selfBACK on low back pain related disability and the findings and the process evaluation performed in parallel will inform how to further develop the app to increase the effectiveness.
PainRelief.com: What recommendations do you have for future research as a result of this work?
Response: Further research should focus on investigating if there are any subgroups that do or do not benefit from this type of digital self-management support. To learn about who engages with a digital intervention may inform further development on how to strengthen user engagement and thereby provide more effective self-management support.
In the future, the selfBACK app may be developed to a commercial product.
Sandal LF, Bach K, Øverås CK, et al. Effectiveness of App-Delivered, Tailored Self-management Support for Adults With Lower Back Pain–Related Disability: A selfBACK Randomized Clinical Trial. JAMA Intern Med. Published online August 02, 2021. doi:10.1001/jamainternmed.2021.4097
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