Barriers and facilitators to patient uptake and utilisation of digital interventions for the self-management of low back pain: a systematic review of qualitative studies

ObjectivesLow back pain (LBP) is a leading contributor to disability globally. Self-management is a core component of LBP management. We aimed to synthesise published qualitative literature concerning digital health interventions (DHIs) to support LBP self-management to: (1) determine engagement strategies, (2) identify barriers and facilitators affecting patient uptake/utilisation and (3) develop a preliminary conceptual model of barriers and facilitators to uptake/utilisation.DesignSystematic review following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines.Data sourcesMEDLINE, Embase, CINAHL, PsycINFO, Cochrane Library, DoPHER, TRoPHI, Web of Science and OT Seeker, from January 2000 to December 2018, using the concepts: LBP, DHI and self-management.Eligibility criteriaPeer-reviewed qualitative study (or component) examining engagement with, or barriers and/or facilitators to the uptake/utilisation of an interactive DHI for self-management of LBP in adults (community, primary or secondary care settings).Data extraction and synthesisStandardised data extraction form was completed. COREQ (Consolidated criteria for Reporting Qualitative research) checklist was used to assess methodology. Data was synthesised narratively for engagement strategies, thematically for barriers/facilitators to uptake/utilisation and normalisation process theory was applied to produce a conceptual model.ResultsWe identified 14 191 citations, of which 105 full-text articles were screened, and five full-text articles from four studies included. These were from community and primary care contexts in Europe and the USA, and involved 56 adults with LBP and 19 healthcare professionals. There was a lack of consideration on how to sustain engagement with DHIs. Examination of barriers and facilitators for uptake/utilisation identified four major themes: IT (information technology) usability–accessibility; quality–quantity of content; tailoring–personalisation; and motivation–support. These themes informed the development of a preliminary conceptual model for uptake/utilisation of a DHI for LBP self-management.ConclusionsWe highlight key barriers and facilitators that should be considered when designing DHIs for LBP self-management. Our findings are in keeping with reviews of DHIs for other long-term conditions, implying these findings may not be condition specific.Systematic review registrationA protocol for this systematic review was registered with https://www.crd.york.ac.uk/PROSPERO/ (CRD42016051182) on 10 November 2016. https://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42016051182

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Effectiveness of smartphone apps for the self-management of low back pain in adults: a systematic review

Disability and Rehabilitation ◽

10.1080/09638288.2021.2005161 ◽

2021 ◽

pp. 1-10

Author(s):

Claudia Didyk ◽

Lucy Kate Lewis ◽

Belinda Lange

Keyword(s):

Systematic Review ◽

Low Back Pain ◽

Back Pain ◽

The Self ◽

Self Management ◽

Low Back ◽

Smartphone Apps

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Smartphone apps for the self-management of low back pain: A systematic review

Best Practice & Research Clinical Rheumatology ◽

10.1016/j.berh.2017.04.002 ◽

2016 ◽

Vol 30 (6) ◽

pp. 1098-1109 ◽

Cited By ~ 51

Author(s):

Gustavo C. Machado ◽

Marina B. Pinheiro ◽

Hopin Lee ◽

Osman H. Ahmed ◽

Paul Hendrick ◽

...

Keyword(s):

Systematic Review ◽

Low Back Pain ◽

Back Pain ◽

The Self ◽

Self Management ◽

Low Back ◽

Smartphone Apps

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Involving clinical staff members in the management of low back pain in general practice: a qualitative interview study

10.21203/rs.2.11548/v1 ◽

2019 ◽

Author(s):

Randi Hessellund Knudsen ◽

Janus Laust Thomsen ◽

Camilla Aakjaer Andersen ◽

Tamana Afzali ◽

Allan Riis

Keyword(s):

General Practice ◽

Low Back Pain ◽

Back Pain ◽

Patient Education ◽

Clinical Staff ◽

Barriers And Facilitators ◽

Self Management ◽

Low Back ◽

Staff Members ◽

Member Involvement

Abstract Background Low back pain (LBP) is the leading cause of disability worldwide. Patient education and self-management have the potential to improve the care of patients. However, high workload and little available time for consultations are argued to challenge the delivery of optimal care in general practice. Involving clinical staff members in the management of diabetes and of patients with hypertension has shown to be feasible. Consequently, involving clinical staff members in providing education and information to patients may improve the delivery of patient information and education. However, this require a shift in the division of tasks and general practitioners’ (GPs’) barriers and facilitators for this is currently unknown. The aim is to explore GPs’ barriers and facilitators to involve clinical staff members in the treatment of LBP in general practice. Methods This is a qualitative, semi-structured interview study. We used the phenomenological approach to study experiences and attitudes towards changing the management of patients with LBP from the GPs’ perspectives. Analysis was conducted using inductive descriptive methods. Results We conducted five 60-minute interviews with Danish GPs. All GPs had experience with task delegation, but it varied which tasks the GPs delegated and to which types of clinical staff members. The following barriers towards clinical staff member involvement were identified: Patients with LBP is a heterogeneous group with a variety of treatment needs, the examination and treatment can be considered as one coherent process, and it would require external support. Involving clinical staff members can release GP time. Another facilitator was the possibility for improving the uptake of clinical guidelines and involvement of practice nurses was considered to improve the provision of patient education and lead to greater patient self-management. Conclusion While some GPs currently consider delegation to clinical staff members a good idea in the treatment of LBP, others prefer the existing treatment strategy without clinical staff member involvement. Consequently, healthcare providers need to address existing barriers and facilitators for involving clinical staff members when advocating for a future multi professional treatment strategy of LBP in general practice.

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