Evaluation of a Mobile Application for Chronic Low Back Pain Management: Prospective Pilot Study (Preprint)

Abstract

BACKGROUND Chronic low back pain is challenging to manage due to multidisciplinary considerations. It bears substantial socioeconomic impact and cannot be simply treated with pharmacotherapy, nonsurgical intervention, or spine surgery. Medical consensus recommends optimizing conservative, self-management therapies (e.g., home exercise, wellness strategies, yoga, etc.) as first-line treatment options for chronic low back pain. However, access to these modalities is often limited secondary to cost, convenience, and ease of use. Mobile health applications have emerged as a cost-effective and accessible option for chronic low back pain self-management. OBJECTIVE This was a pilot study evaluating the PainNavigator platform to inform future trial development. METHODS 75 participants using PainNavigator were studied. PEG-3 and a brief anxiety and depression scale based on the PHQ-4 scores were obtained at baseline and following program completion. PEG-3 total score was used, in addition to individual items, Average Pain, Pain Effect on Enjoyment, and Pain Effect on Activity. PHQ-4 total score was also used, in addition to the individual items including, Felt Depressed, Loss of Interest, Felt Anxious, and Difficult to Control Worry. Paired sample t-tests compared mean differences before and after participants received the intervention. RESULTS The analysis found that PEG-3 (n=27) and PHQ-4 (n=27) total scores were significantly lower upon completion of PainNavigator (P<.001 and P=.001, respectively). The findings show a 36% reduction in PEG-3 total score, 40% reduction in Pain Intensity, and a 40% reduction in PHQ-4 total score. Individual PEG-3 and PHQ-4 items were also significantly decreased. All measures had medium to large effect sizes. CONCLUSIONS These findings show that PainNavigator has clinical significance in managing chronic low back pain and can be easily utilized to improve patient care. This study will also inform future randomized controlled trials and quality improvement.