Accepted for/Published in: JMIR Research Protocols
Date Submitted: May 7, 2019
Open Peer Review Period: May 10, 2019 - May 24, 2019
Date Accepted: Sep 24, 2019
(closed for review but you can still tweet)
A Protocol for a Pain eHealth Platform Study for Engaging Older, Obese Adults with Chronic Low Back Pain in Non-Pharmacological Pain Treatments
ABSTRACT
Background:
Low back pain (LBP) is a costly healthcare problem and the leading cause of disability among adults in the United States. Primary care providers (PCPs) urgently need effective ways to deliver evidence-based, non-pharmacological therapies for chronic LBP. Guidelines published by several government and national organizations have recommended non-pharmacological therapies for LBP.
Objective:
The Pain eHealth Platform (PEP) pilot trial aims to test the feasibility of a highly innovative three-part intervention that: 1) uses an electronic health record (EHR) query to systematically identify a phenotype of obese, older adults with chronic LBP who may benefit from web-based behavioral treatments; 2) delivers highly-tailored messages to eligible older adults with LBP via the patient portal; 3) links affected patients to a Web application (Web app) that provides education regarding the efficacy of evidence-based, non-pharmacological, behavioral pain treatments; and 4) directs patients to existing web-based health treatment tools.
Methods:
Using a three-step modified Delphi method, an expert panel of PCPs will define a LBP phenotype for an EHR query. Using the defined LBP phenotype, an EHR query will be created to identify patients who may benefit from the PEP. Up to 15 LBP patients will be interviewed to refine the tailored messaging, aesthetics, and content of the patient-facing Web app within the PEP. Up to 10 PCPs will be interviewed to better understand the facilitators and barriers to implementing the PEP given their clinic workflow. We will assess the feasibility of the PEP in a single-arm pragmatic pilot study in which secure patient portal invitations containing a hyperlink to the PEP Web app are sent to 1,000 patients. The primary outcome of the study is acceptability and usability as measured by the System Usability Scale (SUS).
Results:
Qualitative interviewing of PCPs is ongoing as of April 2019.
Conclusions:
The PEP will leverage informatics and the patient portal to deliver evidence-based non-pharmacological treatment information to adults with chronic LBP. Results from this study may help inform the development of web-based health platforms for other pain and chronic health conditions.
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