@Article{info:doi/10.2196/jmir.3474,
author="Riva, Silvia
and Camerini, Anne-Linda
and Allam, Ahmed
and Schulz, Peter J",
title="Interactive Sections of an Internet-Based Intervention Increase Empowerment of Chronic Back Pain Patients: Randomized Controlled Trial",
journal="J Med Internet Res",
year="2014",
month="Aug",
day="13",
volume="16",
number="8",
pages="e180",
keywords="Internet-based intervention; interactivity; patient empowerment; chronic back pain; health outcomes; decision; health; physical activity; pain burden; medication misuse; gamification",
abstract="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, $\eta$2=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). ",
issn="1438-8871",
doi="10.2196/jmir.3474",
url="http://www.jmir.org/2014/8/e180/",
url="https://doi.org/10.2196/jmir.3474",
url="http://www.ncbi.nlm.nih.gov/pubmed/25119374"
}