TESTING THE FEASIBILITY OF A DIGITAL EDUCATION PROGRAMME FOR OLDER PEOPLE WORKING WITH PERSISTENT LOW BACK PAIN

S. Mc Donough^1,2, S. Howes², C. Larsson³, F. Piccinini⁴, E. Casoni⁵, E. Hansson³, J. Marley²

¹RCSI University of Medicine and Health Sciences, School of Physiotherapy, Dublin, Ireland, ²Ulster University, School of Health Sciences, Londonderry, United Kingdom, ³Lund University, Human Movement Health and Rehabilitation, Lund, Sweden, ⁴INCRA, Centre for Socio-Economic Research and Ageing, Ancona, Italy, ⁵INCRA, Institute for Socio-Economic Research and Ageing, Ancona, Italy

Background: Low back pain (LBP) is the main cause of activity limitation and work absence worldwide, contributing to a high economic and social burden. Self-management is the key recommendation for managing LBP, and online, digital interventions have potential to support and provide unrestricted access to self-management strategies for LBP.

Purpose: The aim of this multi-centre, multi-national feasibility study was to explore the feasibility, usability and acceptability of an online education programme, called “MyRelief”.

Methods: Uncontrolled study with older adults (aged ≥50 years) in employment with persistent, non-specific LBP. Participants received four weeks access to the MyRelief educational platform, which comprised short, evidence-based modules related to understanding and managing their LBP e.g. psychological factors, physical activity and exercise and communication with healthcare providers. Trial feasibility was assessed based on pre-defined criteria related to recruitment, retention rates, and user acceptability (measured by the System Usability Scale (SUS) scores). A sub-group of participants provided qualitative feedback on their perceptions of the acceptability of the system. We recorded baseline demographics. Secondary outcomes included clinical measures such as the Oswestry Disability Questionnaire (ODQ), EQ-5D-3L were measured at baseline and at one month and an adapted version of the Patient enablement Instrument (PEI) at one month only; we checked quality and completion rates.

Results: We recruited 80% of our planned participants (n=40/50) and met our a priori feasibility criteria of >70% recruitment rate. The recruited population met our expected characteristics in that they were over 50 years of age (mean±SD , 57.3± 4.2), had persistent low back pain (mean±SD, 11.5±10.5 years), were working (occupation categories: 70% sedentary, 25% light and 5% heavy manual), with half demonstrating moderate functional disability levels at baseline (47% ODQ scores >21). In terms of retention rate, we did not meet our a priori feasibility criteria of <35%. Our drop-out rate was 45% (n=18/40); all participants completed baseline measures, however only n=22 completed end of study outcomes at one month. Quality of outcome measure completion was good, if completed, although fewer people ODQ completed ODQ at one month (n=17/22). The total mean score for the SUS was 72.4 (95% CI: 67.5-73.3), which would be considered ok/good (Bangor et al, 2008); qualitative feedback confirmed some challenges with usability in terms of access to, and navigation within the website ‘access was a bit complicated at first, but once understood, everything went well’; ‘Difficult to navigate at the webpage’. Other qualitative feedback made suggestions on the content of the website that were both positive and negative e.g. ‘having input from experts from different Countries was very good’; ‘the exercise programme was very difficult’.

Conclusions: This study was feasible in terms of recruitment but not retention. About half of our sample had low levels of functional disability; in future, recruitment via healthcare providers may be more appropriate.Our usability scores suggest our website meets minimal industry standards.Completion of outcomes was good, apart from ODQ.

Implications: These finding will help us refine for a future study.

Funding acknowledgements: Co-funded by the Erasmus programme of the European Union, project-ID: 2018-1-SE01-KA204-039144.

Keywords:
Low back pain
self-management
digital

Topics:
Musculoskeletal: spine
Education
Health promotion & wellbeing/healthy ageing/physical activity

Did this work require ethics approval? Yes

Institution: Ulster University

Committee: Institutional Research Ethics Committee

Ethics number: REC/20/0045