The influence of a biopsychosocial educational internet-based intervention on pain, dysfunction, quality of life, and pain cognition in chronic low back pain patients in primary care: a mixed methods approach

Abstract

BackgroundLow back pain is the highest reported musculoskeletal problem worldwide. Up to 90 % of patients with low back pain have no clear explanation for the source and origin of their pain. These individuals commonly receive a diagnosis of non-specific low back pain.Patient education is a way to provide information and advice aimed at changing patients’ cognition and knowledge about their chronic state through the reduction of fear of anticipatory outcomes and the resumption of normal activities. Information technology and the expedited communication processes associated with this technology can be used to deliver health care information to patients. Hence, this technology and its ability to deliver life-changing information has grown as a powerful and alternative health promotion tool.Several studies have demonstrated that websites can change and improve chronic patients’ knowledge and have a positive impact on patients’ attitudes and behaviors. The aim of this project is to identify chronic low back pain patients’ beliefs about the origin and meaning of pain to develop a web-based educational tool using different educational formats and gamification techniques.Methods/designThis study has a mixed-method sequential exploratory design. The participants are chronic low back pain patients between 18–65 years of age who are attending a primary care setting. For the qualitative phase, subjects will be contacted by their family physician and invited to participate in a personal semi-structured interview. The quantitative phase will be a randomized controlled trial. Subjects will be randomly allocated using a simple random sample technique. The intervention group will be provided access to the web site where they will find information related to their chronic low back pain. This information will be provided in different formats. All of this material will be based on the information obtained in the qualitative phase. The control group will follow conventional treatment provided by their family physician.DiscussionThe main outcome of this project is to identify chronic low back pain patients’ beliefs about the origin and meaning of pain to develop a web-based educational tool using different educational formats and gamification techniques.Trial registrationClinicalTrials.gov NCT02369120 Date: 02/20/2015.Electronic supplementary materialThe online version of this article (doi:10.1186/s12911-015-0220-0) contains supplementary material, which is available to authorized users.

Digital Support Interventions for the Self-Management of Low Back Pain: A Systematic Review

“…The following approaches were mentioned as underpinning or rationales for the intervention: mindfulness [28], person-based approach [31], and self-management principles (not specified further) [29]; and tools such as goal setting [33] and information on pain and pain etiology [32,36]. Finally, 2 studies also reported that the advice given to participants was based on treatment guidelines, either evidence-based or recommendations from Governmental Institutes [27,37].…”

“…Better consistency in choice of outcome measures was seen in the 3 RCT protocols of planned RCTs [27,31,36]. We expect that these trials will provide more useful information and data for future meta-analyses.…”

Peer Review #2 of "Patient-reported outcomes measured with and without dizziness associated with non-specific chronic neck pain: implications for primary care (v0.2)"

“…It is important for nurses and clinicians to evaluate all dimensions of the pathology since only by using a biopsychosocial approach can we understand the patient's condition and intervene satisfactorily, thus avoiding the progression of high chronicity with its associated socio-sanitary costs given the high perceived disability that we report in this work (Valenzuela-Pascual et al, 2015).…”

A biopsychosocial understanding of lower back pain: Content analysis of online information

“…The Internet has become a leading resource for the dissemination of health information to the public (Ahmed et al., ; Bailey et al., ; Demetriades et al., ; Nielsen et al., ; Palermo et al., ; Valenzuela‐Pascual et al., ). Over 3.3 billion people access the Internet worldwide (Miniwatts Marketing Group, ) and 80% of users within the United States are estimated to access health information online (Fox, ).…”

“…Popularity of the search term ‘lower back pain’ within the Google search engine has been consistently increasing (Google, ), compared to other related search terms that are specific to the lower back (Google, ), an observation that reflects the public trend towards seeking freely available online LBP information. Education is a critical aspect to LBP management (Dagenais et al., ); therefore, it seems reasonable to suggest that increased access to health information could aid in the management of such a burden, yet LBP disability remains substantially high as online access to health information continues to rise (Ahmed et al., ; Bailey et al., ; Demetriades et al., ; Nielsen et al., ; Palermo et al., ; Valenzuela‐Pascual et al., ). An understanding of current online LBP information and how its content compares to a current understanding of LBP is critical if the Internet is to become an effective educational resource in LBP management.…”