This study evaluates the feasibility and effectiveness of the STarT BACK and SelfBack tools in improving the self-management of LBP among patients in a Saudi Arabian primary care setting, focusing on patient self-management outcomes and system integration.
An individual randomized feasibility pilot trial was conducted at King Saud University’s primary care clinics. Participants included adults diagnosed with LBP (n=56) who were smartphone users. High-risk patients and those with specific contraindications were excluded. Participants were randomly assigned to either the intervention group (n=26), receiving usual care plus SelfBACK app guidance, or a control group (n=30) receiving standard care. Data on demographics, clinical outcomes, healthcare resource utilization, and patient and clinician experiences were collected and analyzed. Qualitative feedback was obtained from five primary care physicians, to capture insights into the operational aspects of the SelfSTarT approach.
Participants’ adherence to the digital intervention was high, with participants reporting positive experiences with the SelfBACK app. Clinical outcomes between the intervention and control groups showed no significant differences in musculoskeletal health quality (MSK-HQ) scores at follow-up. Physician interviews revealed supportive attitudes towards using the STarT back tool to stratify patients and digital tools for self-management. However, they suggested modifications for better clinical integration.
While the study did not result in significant changes in clinical outcomes, it did underscore the potential of digital interventions to engage individuals in Saudi Arabia's primary care setting in managing their own low back pain. Healthcare practitioners emphasize the critical need for customized digital solutions that are easily integrated into current clinical workflows.
In physiotherapy practice, the study highlights the potential for digital tools to promote patient self-management, personalize care through risk stratification, and improve musculoskeletal outcomes. These tools could enable more efficient management of LBP, reducing the burden on healthcare providers.
In terms of management, successfully integrating digital interventions could streamline referrals and enhance resource utilization by minimizing unnecessary visits while promoting efficient, individualized care pathways.
For education, the study underscores the need to train future physiotherapists in using digital tools and stratification methods, preparing them for technology-enhanced clinical environments. Additionally, it emphasizes the importance of educating patients on self-management techniques, fostering greater autonomy in managing their conditions.
From a policy perspective, the results could guide healthcare policies advocating for integrating digital tools in primary care. This could lead to standardized care pathways that ensure patients receive appropriate care based on their risk profiles, improving healthcare delivery in Saudi Arabia.
STarT Back
digital intervention, self-management
