Programme no. 562-P
Stratifying information and advice in a tailored web-application for patients with low back pain: study protocol of a randomised controlled trial
Allan Riis*1, Anne Marie Kanstrup2, Jan Hartvigsen3, Pernille Bertelsen4, Henrik Schroll5, Martin Bach Jensen6
1Research Unit for General Practice,Department of Clinical Medicine, Aalborg University,9220 Aalborg Ø,Denmark, 2Department of Communication, Center for User Driven Innovation, Learning and Design,Aalborg University,9000 Aalborg,Denmark, 3Department of Sports Science and Clinical Biomechanics, Clinical Biomechanics and Musculoskeletal Research, Research Unit for Clinical Biomechanics,University of Southern Denmark,Odense,Denmark, 4Department of Development and Planning,Aalborg University,9000 Aalborg,Denmark, 5Research Unit for General Practice in the North Denmark Region,9220 Aalborg Ø,Denmark, 6Research Unit for General Practice,Department of Clinical Medicine, Aalborg University,9220 Aalborg Ø,Denmark
* = Presenting author
Objectives: The aim of this trial is to compare a web-application with advice based on StarT Back stratification with the same web-application without stratification for patients seeking care for LBP at their general practitioner.
Background: Patients´ competence and self-care opportunities are important when treating low back pain (LBP). Involving patients in the design and development of a web-application may help healthcare providers to address possible barriers for usage and thereby increasing patients´ acceptance and usage of a web-application. Furthermore, stratifying LBP patients using the STarT Back Tool, and target the right treatment to the right patient has been shown to be more effective than a one size fits all treatment approach.
Results: Development of the web-application will be done in 2015.
Material/Methods: This is a triple blinded randomised controlled trial. Five hundred LBP patients aged ≥ 18 years will be included. Excluded are patients with red flags (serious pathology), without Danish reading skills, without internet access, and pregnant women. Patients are randomised 1:1 for each Start Back stratum. A cost-effectiveness analysis will be conducted alongside the trial, along with a process evaluation of patient satisfaction with and the use of web-applications. In addition we describe the development of the web-application tailored to patients´ preferences. Patient identification data (personal identification number and Email address) are collected via electronic pop-ups in general practice at baseline. Patient reported outcomes are collected at baseline and repeated after 4, 8, and 12 weeks via electronic questionnaires. Referral to hospital care and other health related costs are collected via registers with 12 weeks follow-up.
Conclusion: The randomised controlled trial will be conducted in 2016.
Points for discussion: To our knowledge, this will be the first trial to study the effects of involving patients in the tailoring of a web-application and to stratify LBP advices on the internet.