TY - JOUR
T1 - Impact on productivity impairment of a digital care program for chronic low back pain
T2 - A prospective longitudinal cohort study
AU - Areias, Anabela C.
AU - Costa, Fabíola
AU - Janela, Dora
AU - Molinos, Maria
AU - Moulder, Robert G.
AU - Lains, Jorge
AU - Scheer, Justin K.
AU - Bento, Virgílio
AU - Yanamadala, Vijay
AU - Cohen, Steven P.
AU - Correia, Fernando Dias
N1 - Publisher Copyright:
© 2022 The Authors
PY - 2023/2
Y1 - 2023/2
N2 - Background: Low back pain (LBP) is the leading cause of disability in the United States and the main reason for absenteeism. Successful management of chronic LBP (CLBP) is dependent on multimodal evidence-based interventions. Digital interventions (DI) may ease accessibility to such treatments, increasing adherence, while reducing healthcare-related costs. Objectives: Assess the impact of a completely remote multimodal DI on productivity impairment in a real-work context cohort of patients with CLBP. Design: Longitudinal study. Methods: Ad-hoc analysis of an interventional, single-arm study of individuals with CLBP undergoing a DI for 12 weeks. Outcomes included the mean change in work productivity and activity impairment (including overall and non-work related activities), pain, depression, anxiety, fear-avoidance beliefs, analgesic usage, and engagement. Minimal clinically important change (MCIC) was calculated for productivity using anchor- and distribution-based methods. Results: From 560 patients at program start, 78.4% completed the DI. A significant improvement in overall productivity (20.21, 95%CI: 16.48–23.94) and in non-work related activities (21.36, 95%CI: 17.49–25.22) was observed, corresponding to a responder rate of 57.1–83.3% and 60.5–79.8%, respectively, and depending on the MCIC method. Significant improvements were reported for pain (2.32 points, 95%CI: 2.02–2.61), anxiety (5.24, 95%CI: 4.18–6.29), depression (6.38, 95%CI: 4.78–7.98) and fear-avoidance beliefs (8.11, 95%CI: 6.20–10.02). Both engagement (sessions per week) and patient satisfaction scores were high, 2.9 (SD 1.0) and 8.8/10 (SD 1.6), respectively. Conclusions: This study demonstrated the utility of a multimodal DI to address productivity impairment. DIs have great potential to ease the burden of CLBP, providing an accessible and cost-effective modality of care. Trial registration: The study was approved by the New England IRB (protocol number 120190313) and prospectively registered in ClinicalTrials.gov, NCT04092946, on September 17th, 2019.
AB - Background: Low back pain (LBP) is the leading cause of disability in the United States and the main reason for absenteeism. Successful management of chronic LBP (CLBP) is dependent on multimodal evidence-based interventions. Digital interventions (DI) may ease accessibility to such treatments, increasing adherence, while reducing healthcare-related costs. Objectives: Assess the impact of a completely remote multimodal DI on productivity impairment in a real-work context cohort of patients with CLBP. Design: Longitudinal study. Methods: Ad-hoc analysis of an interventional, single-arm study of individuals with CLBP undergoing a DI for 12 weeks. Outcomes included the mean change in work productivity and activity impairment (including overall and non-work related activities), pain, depression, anxiety, fear-avoidance beliefs, analgesic usage, and engagement. Minimal clinically important change (MCIC) was calculated for productivity using anchor- and distribution-based methods. Results: From 560 patients at program start, 78.4% completed the DI. A significant improvement in overall productivity (20.21, 95%CI: 16.48–23.94) and in non-work related activities (21.36, 95%CI: 17.49–25.22) was observed, corresponding to a responder rate of 57.1–83.3% and 60.5–79.8%, respectively, and depending on the MCIC method. Significant improvements were reported for pain (2.32 points, 95%CI: 2.02–2.61), anxiety (5.24, 95%CI: 4.18–6.29), depression (6.38, 95%CI: 4.78–7.98) and fear-avoidance beliefs (8.11, 95%CI: 6.20–10.02). Both engagement (sessions per week) and patient satisfaction scores were high, 2.9 (SD 1.0) and 8.8/10 (SD 1.6), respectively. Conclusions: This study demonstrated the utility of a multimodal DI to address productivity impairment. DIs have great potential to ease the burden of CLBP, providing an accessible and cost-effective modality of care. Trial registration: The study was approved by the New England IRB (protocol number 120190313) and prospectively registered in ClinicalTrials.gov, NCT04092946, on September 17th, 2019.
KW - Chronic pain
KW - Minimal clinically important change
KW - Presenteeism
KW - Remote care
KW - Telerehabilitation
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U2 - 10.1016/j.msksp.2022.102709
DO - 10.1016/j.msksp.2022.102709
M3 - Article
C2 - 36543719
AN - SCOPUS:85144402475
SN - 2468-8630
VL - 63
JO - Musculoskeletal Science and Practice
JF - Musculoskeletal Science and Practice
M1 - 102709
ER -