Effect of a Consumer-Focused Website for Low Back Pain on Health Literacy, Treatment Choices, and Clinical Outcomes: Randomized Controlled Trial (Preprint)

Abstract

BACKGROUND The internet is used for information related to health conditions, including low back pain (LBP), but most LBP websites provide inaccurate information. Few studies have investigated the effectiveness of internet resources in changing health literacy or treatment choices. OBJECTIVE This study aims to evaluate the effectiveness of the MyBackPain website compared with unguided internet use on health literacy, choice of treatments, and clinical outcomes in people with LBP. METHODS This was a pragmatic, web-based, participant- and assessor-blinded randomized trial of individuals with LBP stratified by duration. Participants were randomly allocated to have access to the evidence-based MyBackPain website, which was designed with input from consumers and expert consensus or unguided internet use. The coprimary outcomes were two dimensions of the Health Literacy Questionnaire (dimension 2: “having sufficient information to manage my health;” dimension 3: “actively managing my health;” converted to scores 1-100) at 3 months. Secondary outcomes included additional Health Literacy Questionnaire dimensions, quality of treatment choices, and clinical outcomes. RESULTS A total of 453 participants were recruited, and 321 (70.9%) completed the primary outcomes. Access to MyBackPain was not superior to unguided internet use on primary outcomes (dimension 2: mean difference −0.87 units, 95% CI −3.56 to 1.82; dimension 3: mean difference −0.41 units, 95% CI −2.78 to 1.96). Between-group differences in other secondary outcomes had inconsistent directions and were unlikely to be clinically important, although a small improvement of unclear importance in the quality of stated treatment choices at 1 month was found (mean difference 0.93 units, 95% CI 0.03 to 1.84). CONCLUSIONS MyBackPain was not superior to unguided internet use for health literacy, but data suggest some short-term improvement in treatment choices. Future research should investigate if greater interactivity and engagement with the website may enhance its impact. CLINICALTRIAL Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12617001292369; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=372926 INTERNATIONAL REGISTERED REPORT RR2-10.1136/bmjopen-2018-027516

Digital self-care in the management of spine musculoskeletal disorders: A systematic review and meta-analysis

“…Regarding the design of the studies, all of them were RCTs, published between 2002 and 2022 with predominance of 2019 with 6 (24%) (2,(6)(7)(18)(19)(20) and of 2021 with 4 (16%) (8,15,(21)(22) . Of the 25 studies, 9 (36%)…”

“…were conducted in the United States of America (6,21,(23)(24)(25)(26)(27)(28)(29) , 5 (20%) in Australia (8,(18)(19)(20)30) , 3 (12%) in Germany (2,14,31) , 2 (8%) in Spain (17,32) , and 1 (4%) each in several countries such as India (33) , Netherlands (7) , Iran (15) , Jordan (16) , Italy (34) , Denmark and Norway (22) . The overall total was 5,142 participants, varying from 30 to 779 subjects in each study; 9 (36%) studies had sample sizes smaller than 100 participants (2,(14)(15)(16)(17)(18)(19)30,33) .…”

“…Regarding the digital therapeutic technologies, 9 (36%) used smartphone apps (2,6,(15)(16)19,22,26,31,33) , 9 (36%) resorted to websites and online programs (7)(8)17,20,(23)(24)(27)(28)32) , 2 (8%) employed telephones (25,30) , 1 (4%) chat discussion (14) , 1 (4%) email (29) , 1 (4%) virtual reality (21) , 1 (4%) Telemedicine (34) , and 1 (4%) video game (18) .…”

“…In general, the interventions involved physical exercises (2,(6)(7)(15)(16)(17)(18)(19)22,27,(31)(32)(33)(34) , education (2,(6)(7)(8)(21)(22)(23)(26)(27)29,32) and CBT (6,(20)(21)(23)(24)(25)(26)30) . The physical exercises were provided in the form of videos, audios or image-based instructions and could include performance feedback or not.…”

“…Websites, programs and apps containing diverse and reliable information that meets the consumers' needs are still missing. More research studies are necessary to assess if knowledge improves the results and behaviors (8) .…”