Interactive sections of an Internet-based intervention increase empowerment of chronic back pain patients: Randomized controlled trial

Background: chronic back pain (cbp) represents a significant public health problem. as one of the most common causes of disability and sick leave,there is a need to develop cost-effective ways,such as internet-based interventions,to help empower patients to manage their disease. research has provided evidence for the effectiveness of internet-based interventions in many fields,but it has paid little attention to the reasons why they are effective. objective: this study aims to assess the impact of interactive sections of an internet-based self-management intervention on patient empowerment,their management of the disease,and,ultimately,health outcomes. methods: a total of 51 patients were recruited through their health care providers and randomly assigned to either an experimental group with full access to the internet-based intervention or a control group that was denied access to the interactive sections and knew nothing thereof. the intervention took 8 weeks. a baseline,a mid-term after 4 weeks,and a final assessment after 8 weeks measured patient empowerment,physical exercise,medication misuse,and pain burden. results: all patients completed the study. overall,the intervention had a moderate effect (f1.52=2.83,p=.03,η2=0.30,d=0.55). compared to the control group,the availability of interactive sections significantly increased patient empowerment (midterm assessment: mean difference=+1.2,p=.03,d=0.63; final assessment: mean difference=+0.8,p=.09,d=0.44) and reduced medication misuse (midterm assessment: mean difference=-1.5,p=.04,d=0.28; final assessment: mean difference=-1.6,p=.03,d=-0.55) in the intervention group. both the frequency of physical exercise and pain burden decreased,but to equal measures in both groups. conclusions: results suggest that interactive sections as part of internet-based interventions can positively alter patients' feelings of empowerment and help prevent medication misuse. detrimental effects were not observed. trial registration: clinicaltrials.gov: nct02114788; http://www.clinicaltrials.gov/ct2/show/nct02114788 (archived by webcite at http://www.webcitation.org/6roxyvopr). ©silvia riva,anne-linda camerini,ahmed allam,peter j schulz.