Can a Back Pain E-mail Discussion Group Improve Health Status and Lower Health Care Costs?: A Randomized Study
Abstract
Background Given the high health care utilization, limited evidence for the effectiveness of back pain interventions, and the proliferation of e-mail health discussion groups, this study seeks to determine if the Internet can be used to improve health status and health care utilization for people with chronic back pain. Methods Randomized controlled trial. Participants included 580 people from 49 states with chronic back pain having at least 1 outpatient visit in the past year, no "red-flag" symptoms, and access to e-mail. Major exclusion criteria included continuous back pain for more than 90 days causing major activity intolerance and/or receiving disability payments. Intervention Closed, moderated, e-mail discussion group. Participants also received a book and videotape about back pain. Controls received a subscription to a non-health-related magazine of their choice. Main outcome measures Pain, disability, role function, health distress, and health care utilization. Results At 1-year treatment, subjects compared with controls demonstrated improvements in pain (P =.045), disability (P =.02), role function (P =.007), and health distress (P =.001). Physician visits for the past 6 months declined by 1.5 visits for the treatment group and by 0.65 visits for the control group (P =.07). Mean hospital days declined nearly 0.20 days for the treated group vs and increased 0.04 days for the control group (P =.24). Conclusions An e-mail discussion group can positively affect health s…
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In a randomized study of a moderated e-mail discussion group for chronic low back pain, participants in the e-mail discussion group exhibited significant improvements in pain, disability, role function, and health distress, as well as a downward trend in physician visits.
“Data analyses showed that participants in the e-mail discussion group exhibited significant improvements in pain, disability, role function, and health distress as well as a downward trend in physician visits.”
From Psychological aspects of persistent pain: Current state of the science (2004) · cites this paper as [67]
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- Authors
- Lorig, K. R., Laurent, D. D., Deyo, R. A., Marnell, M. E., Minor, M. A., & Ritter, P. L.
- Affiliations
- Stanford University (US)
- University of Missouri (US)
- Venue
- Archives of Internal Medicine
- Publisher
- American Medical Association (AMA)
- Published
- 2002-04-08
- Volume
- 162
- Issue
- 7
- Pages
- 792
- ISSN
- 0003-9926 (ISSN-L)
- OpenAlex
- W1990739716
- Cited by
- 206
- References
- 15
- Citations by year
- 2025: 2 · 2024: 2 · 2023: 7 · 2022: 6 · 2021: 2 · 2020: 4 · 2019: 3 · 2018: 5 · 2017: 2 · 2016: 14 · 2015: 4 · 2014: 10 · 2013: 3 · 2012: 12
- FWCI
- 37.52
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5r01ar044939-04)
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (R01 AR44939-02)
- Topics
- Health Sciences › Health Professions › General Health Professions › Health Literacy and Information Accessibility
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Keywords
- chronic back pain, online intervention, health care utilization, health care costs, pain intensity, disability, role functioning, health distress, physician visits, hospitalization
- MeSH terms
- Back Pain, Computer Communication Networks, Female, Health Education, Health Services, Health Status, Humans, Male, Middle Aged, Patient Acceptance of Health Care, Surveys and Questionnaires, Self-Help Groups, United States, Case-Control Studies
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