Using an internet intervention to support self-management of low back pain in primary care: findings from a randomised controlled feasibility trial (SupportBack)

Adam W. A. Geraghty, Rose Stanford, Beth Stuart, Paul Little, Lisa C. Roberts, Nadine E. Foster, Jonathan C. Hill, Elaine M. Hay, David Turner, Wansida Malakan, Linda Leigh, Lucy Yardley

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Objective: To determine the feasibility of a randomised controlled trial of an internet intervention for low back pain (LBP) using 3 arms: 1) usual care, 2) usual care plus an internet intervention or 3) usual care plus an internet intervention with additional physiotherapist telephone support.
Design and setting: A three-armed randomised controlled feasibility trial conducted in 12 general practices in England.
Participants: Primary care patients aged over 18, with current LBP, access to the internet, and without indicators of serious spinal pathology or systemic illness.
Interventions: The ‘SupportBack’ internet intervention delivers a 6-week, tailored programme, focused on graded goal setting, self-monitoring, and provision of tailored feedback to encourage physical activity. Additional physiotherapist telephone support consisted of three brief telephone calls over a 4-week period, to address any concerns and provide reassurance.
Outcomes: The primary outcomes were the feasibility of the trial design including recruitment, adherence and retention at follow-up. Secondary descriptive and exploratory analyses were conducted on clinical outcomes including LBP-related disability at 3 months follow-up.
Results: Primary outcomes: 87 patients with LBP were recruited (target 60-90) over 6 months, and there were 3 withdrawals. Adherence to the intervention was higher in the physiotherapist-supported arm, compared to the stand-alone internet intervention. Trial physiotherapists adhered to the support protocol. Overall follow-up rate on key clinical outcomes at three months follow-up was 84%.
Conclusions: This study demonstrated the feasibility of a future definitive randomised controlled trial to determine the clinical and cost effectiveness of the SupportBack intervention in primary care patients with LBP.

Trial registration: ISRCTN 31034004

Key words: Low back pain; internet intervention; self-management; primary care
Original languageEnglish
Article numbere016768
JournalBMJ Open
Issue number3
Publication statusPublished - 9 Mar 2018

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