SmartBack: a preliminary study of remotely-delivered, personalized education for patients with chronic low back pain

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BACKGROUND: Low back pain (LBP) is a leading cause of disability worldwide. Despite evidence in clinical practice guidelines (CPGs) emphasizing rehabilitation and self-management education as first-line interventions, uptake of successful self-management strategies is suboptimal. This study assesses a remotely-delivered method of personalized self-management education for patients with chronic LBP (cLBP) who are not actively receiving rehabilitation care. OBJECTIVE: This study evaluated feasibility and effectiveness of a remotely-delivered personalized patient education program, SmartBack, for individuals with cLBP. We hypothesized that the SmartBack program would demonstrate feasibility and lead to improvements in self-efficacy, pain, disability, or any combination of these outcomes in patients with cLBP. METHODS: This single-arm interventional pilot study continuously recruited participants from a local research registry until 30 eligible participants were enrolled. Participants received e-mail surveys every three days for three weeks. Personalized educational materials were distributed to each participant based on their baseline knowledge and beliefs regarding cLBP management and best evidence from nine recent CPGs. Outcome measures were the Pain Self-Efficacy Questionnaire (PSEQ, primary outcome), Numerical Pain Rating Scale (NPRS) and Oswestry Disability Index (ODI). RESULTS: = .026, Cohen's d = 0.596). The mean PSEQ score increased from 29.84 (SD 16.36) to 34.68 (SD 16.75), suggesting that personalized education may positively influence patients' confidence in managing cLBP. Mean ODI and NPRS scores did not significantly change. CONCLUSION: A remotely-delivered, personalized patient education program may be effective in improving self-efficacy among individuals with cLBP. Future research should examine the long-term effects in larger and more diverse populations and using randomized study designs including control groups.