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Titre : | Impact on productivity impairment of a digital care program for chronic low back pain: A prospective longitudinal cohort study (2023) |
Auteurs : | Anabela C. Areias ; Fabíola Costa ; Dora Janela ; Maria Molinos ; Robert G. Moulder ; Jorge Lains ; Justin K. Scheer ; Virgílio Bento ; Vijay Yanamadala ; Steven P. Cohen ; Fernando Dias Correia |
Type de document : | Article |
Dans : | Musculoskeletal Science and Practice (Vol. 63, February 2023) |
Article en page(s) : | 102709 |
Note générale : | https://doi.org/10.1016/j.msksp.2022.102709 |
Langues: | Anglais |
Descripteurs : |
HE Vinci Études de cohortes ; Lombalgie ; Mise en oeuvre des programmes de santé ; Productivité ; Réadaptation ; Télénursing |
Résumé : | Background Low back pain (LBP) is the leading cause of disability in the United States and the main reason for absenteeism. Successful management of chronic LBP (CLBP) is dependent on multimodal evidence-based interventions. Digital interventions (DI) may ease accessibility to such treatments, increasing adherence, while reducing healthcare-related costs. Objectives Assess the impact of a completely remote multimodal DI on productivity impairment in a real-work context cohort of patients with CLBP. Design Longitudinal study. Methods Ad-hoc analysis of an interventional, single-arm study of individuals with CLBP undergoing a DI for 12 weeks. Outcomes included the mean change in work productivity and activity impairment (including overall and non-work related activities), pain, depression, anxiety, fear-avoidance beliefs, analgesic usage, and engagement. Minimal clinically important change (MCIC) was calculated for productivity using anchor- and distribution-based methods. Results From 560 patients at program start, 78.4% completed the DI. A significant improvement in overall productivity (20.21, 95%CI: 16.48?23.94) and in non-work related activities (21.36, 95%CI: 17.49?25.22) was observed, corresponding to a responder rate of 57.1?83.3% and 60.5?79.8%, respectively, and depending on the MCIC method. Significant improvements were reported for pain (2.32 points, 95%CI: 2.02?2.61), anxiety (5.24, 95%CI: 4.18?6.29), depression (6.38, 95%CI: 4.78?7.98) and fear-avoidance beliefs (8.11, 95%CI: 6.20?10.02). Both engagement (sessions per week) and patient satisfaction scores were high, 2.9 (SD 1.0) and 8.8/10 (SD 1.6), respectively. Conclusions This study demonstrated the utility of a multimodal DI to address productivity impairment. DIs have great potential to ease the burden of CLBP, providing an accessible and cost-effective modality of care. Trial registration The study was approved by the New England IRB (protocol number 120190313) and prospectively registered in ClinicalTrials.gov, NCT04092946, on September 17th, 2019. |
Disponible en ligne : | Oui |
En ligne : | https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/article/pii/S2468781222002107 |