This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (59)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Informatics/ Internet in Medicine  • Internet  • Patient Education/ Health Literacy  • Alert me on articles by topic  Social Bookmarking   What's this?

A Randomized Study

Kate R. Lorig, DrPH; Diana D. Laurent, MPH; Richard A. Deyo, MD; Margaret E. Marnell, PhD; Marian A. Minor, PhD; Philip L. Ritter, PhD

Arch Intern Med. 2002;162:792-796.

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 status and possibly health care utilization. It may have a place in the treatment of chronic recurrent back pain.

From Stanford University School of Medicine (Drs Lorig and Ritter and Ms Laurent) and Department of Psychiatry, Stanford University Medical Center (Dr Marnell), Stanford, Calif; University of Washington, School of Medicine, Seattle (Dr Deyo); and Department of Physical Therapy, University of Missouri, Columbia (Dr Minor).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Overtreating Chronic Back Pain: Time to Back Off?
Deyo et al.
J Am Board Fam Med 2009;22:62-68.
ABSTRACT | FULL TEXT  

The Role of Online Support Communities: Benefits of Expanded Social Networks to Patients With Psoriasis
Idriss et al.
Arch Dermatol 2009;145:46-51.
ABSTRACT | FULL TEXT  

Clinical trials studying pharmacotherapy and psychological treatments alone and together
Haythornthwaite
Neurology 2005;65:S20-S31.
ABSTRACT | FULL TEXT  

Nonpharmacologic and Complementary Approaches to Cancer Pain Management
Menefee and Monti
JAOA: Journal of the American Osteopathic Association 2005;105:S15-S20.
ABSTRACT | FULL TEXT  

Automated E-mail Messaging as a Tool for Improving Quit Rates in an Internet Smoking Cessation Intervention
Lenert et al.
J. Am. Med. Inform. Assoc. 2004;11:235-240.
ABSTRACT | FULL TEXT  

Evaluation of ehealth systems and services
Gustafson and Wyatt
BMJ 2004;328:1150-1150.
FULL TEXT  

The Long-term Effects of a Self-management Program for Inner-city Primary Care Patients With Acute Low Back Pain
Damush et al.
Arch Intern Med 2003;163:2632-2638.
ABSTRACT | FULL TEXT  

Innovations in Access to Care: A Patient-Centered Approach
Berry et al.
ANN INTERN MED 2003;139:568-574.
ABSTRACT | FULL TEXT  

Use of the Internet and E-mail for Health Care Information: Results From a National Survey
Baker et al.
JAMA 2003;289:2400-2406.
ABSTRACT | FULL TEXT  

Group Education in Diabetes: Effectiveness and Implementation
Mensing and Norris
Diabetes Spectr. 2003;16:96-103.
ABSTRACT | FULL TEXT  

The doctor, the patient and the world-wide web: how the internet is changing healthcare
Powell et al.
JRSM 2003;96:74-76.
FULL TEXT  

From the Library
Br J Ophthalmol 2002;86:1195-1195.
FULL TEXT  

E-mail Support Group Helps Patients with Back Pain
JWatch General 2002;2002:5-5.
FULL TEXT