Evidence map›Paper›PMID 31811006›Full record

Trial reportBMJ open2019

Effectiveness and cost-utility of a multifaceted eHealth strategy to improve back pain beliefs of patients with non-specific low back pain: a cluster randomised trial.

Arnela Suman, Frederieke G Schaafsma, Johanna M van Dongen, Petra J M Elders, Rachelle Buchbinder, Maurits W van Tulder, Johannes R Anema

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed, 4 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

15 citing papers in PubMed, 4 syntheses or guidelines pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Arnela SumanDepartment of Public and Occupational Health, Amsterdam UMC - Locatie VUMC, Amsterdam, The Netherlands.ORCID 0000-0003-0656-490X
Frederieke G SchaafsmaDepartment of Public and Occupational Health, Amsterdam UMC - Locatie VUMC, Amsterdam, The Netherlands f.schaafsma@vumc.nl.
Johanna M van DongenDepartment of Health Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
Petra J M EldersDepartment of Public and Occupational Health, Amsterdam UMC - Locatie VUMC, Amsterdam, The Netherlands.
Rachelle BuchbinderDepartment of Clinical Epidemiology, Monash University, Clayton, Victoria, Australia.
Maurits W van TulderDepartment of Health Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
Johannes R AnemaDepartment of Public and Occupational Health, Amsterdam UMC - Locatie VUMC, Amsterdam, The Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo assess the effectiveness and cost-utility of a multifaceted eHealth strategy compared to usual care in improving patients' back pain beliefs, and in decreasing disability and absenteeism.

designStepped-wedge cluster randomised trial with parallel economic evaluation.

settingDutch primary healthcare.

participantsPatients diagnosed with non-specific low back pain by their general practitioner or physiotherapist. Patients with serious comorbidities or confirmed pregnancy were excluded. 779 patients were randomised into intervention group (n=331, 59% female; 60.4% completed study) or control group (n=448, 57% female; 77.5% completed study).

interventionsThe intervention consisted of a multifaceted eHealth strategy that included a (mobile) website, digital monthly newsletters, and social media platforms. The website provided information about back pain, practical advice (eg, on self-management), working and returning to work with back pain, exercise tips, and short video messages from healthcare providers and patients providing information and tips. The control consisted of a digital patient information letter. Patients and outcome assessors were blinded to group allocation. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome was back pain beliefs. Secondary outcome measures were disability and absenteeism, and for the preplanned economic evaluation quality of life and societal costs were measured.

resultsThere were no between-group differences in back pain beliefs, disability, or absenteeism. Mean intervention costs were €70- and the societal cost difference was €535-in favour of the intervention group, but no significant cost savings were found. The incremental cost-effectiveness ratio indicated that the intervention dominated usual care and the probability of cost-effectiveness was 0.85 on a willingness-to-pay of €10.000/quality adjusted life year (QALY).

conclusionsA multifaceted eHealth strategy was not effective in improving patients' back pain beliefs or in decreasing disability and absenteeism, but showed promising cost-utility results based on QALYs. TRIAL REGISTRATION NUMBER: NTR4329.

Indexed as

AbsenteeismCost-Benefit AnalysisCulturePhysical Therapy ModalitiesAdultAgedDouble-Blind MethodFemaleHumansLow Back PainMaleMiddle AgedPatient ComplianceSelf ReportTelemedicineeHealthhealth economicslow back painpublic healthrandomised controlled trial

Identifiers

PMID31811006
PMCPMC6924789

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.