Internet-Based Aftercare for Patients with Back Pain—A Pilot Study
Telemedicine and e-Health. July/August 2012, 18(6): 413-419. doi:10.1089/tmj.2011.0221. Markus Moessner, Marcus Schiltenwolf, and Eva Neubauer.
Objective: In order to maintain treatment gains achieved during multidisciplinary treatments for chronic back pain, patients are challenged to implement the behavioral changes they learned during treatment into their daily life. Offering support during the critical time after treatment conclusion helps patients deal with relapses, provides them with practical advice and social support, and helps to master this transfer. As in-person offerings are not always feasible, innovative concepts are needed to enable hospitals to provide aftercare to their patients.
Subjects and Methods: An Internet-based aftercare intervention following multidisciplinary therapy for back pain was constructed, implemented, and evaluated. The aftercare program comprised two modules: (1) an individualized self-monitoring module and (2) a weekly, 90-min chat session moderated by a therapist whom participants already knew from treatment. A randomized controlled trial (n=75) was conducted that compared the post-treatment symptom developments of program participants with symptom developments of controls (treatment as usual [TAU]).
Results: The program was proven to be feasible and well accepted by participants; on average, 68.2% of the participants rated the previous chat session as helpful. Intention-to-treat analyses demonstrated significant effects on post-treatment courses of disability. The largest effects were found for pain-related disability: for TAU participants, disability increased an average of 1.25 scale points (Roland–Morris Questionnaire) per 100 days; for program participants, disability decreased an average of 0.39 scale points (p<0.01).
Conclusions: The aftercare intervention was shown to be feasible and well accepted. Its efficacy should be tested with a larger-scale randomized controlled trial.