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How can we improve the ease of reaching recommended care for people struggling with pain in rural or remote areas?

The internet and technology have dramatically revolutionised the way we live our lives and there is no sign of this stopping. For example, physiotherapy video consultations and exercise apps can be used to deliver or enhance health services. Today there is growing evidence that e-health can help combat the tyranny of distance for people struggling with pain who could benefit from visiting a health professional.

What is the purpose of the study?

We want to learn how to best use e-health to help patients struggling with low back pain, the number one cause of disability in the world, and/or knee pain associated with osteoarthritis, the most common type of arthritis. We want to find out if e-health supported care can improve physical function and pain for people with low back pain or knee osteoarthritis who live outside a big city.

The study is suitable for you if you present the following INCLUSION CRITERIA


1.Pain level:
a.Low back pain: ≥3/10 in the past week
b.Knee: ≥3/10 over most days of the past month


2.Age range:
a.Low back pain: ≥ 18 years old
b.Knee: ≥45 years old


3. Be in the process of seeking care or intending to access care (which incur costs to patients or healthcare system) in the next 3 months for their back and/or knee pain


4.Reside in very remote, remote, inner and outer regional areas (based on the Australian Standard Geographical Classification Remoteness Area)


5.Be fluent in English (verbal and written)


6.Have adequate hearing and eyesight


7.Independent ambulatory status


8.Have current internet access and access to it at least once a month


9.Own an internet-capable device with a display, camera, microphone and speaker(smartphone, tablet or computer).


10.Have a self-rated ability to use the internet at-least fair (using a 4-item scale from poor, fair, good to excellent)


11.Willingness to provide informed consent and willingness to participate and comply with the study requirements.

 

The study is NOT suitable for you if you present ANY of the following EXCLUSION CRITERIA

  1. Recent or imminent spinal surgery (within 12 months)


2. Recent or imminent knee surgery (arthroscopy within 6 months; knee replacements/osteotomy within 12 months)


3. Any recent corticosteroid injections (knee or back in the past month)


4.Evidence of radiculopathy, nerve root, spinal cord, cauda equine compression or lumbar neurogenic claudication


5.Any known suspected serious spinal pathology (fracture, metastatic, inflammatory or infective diseases, widespread neurological disorder)


6.Pain caused by involvement in a road traffic accident in the last 12 months or ongoing litigation


7.Have a comorbid condition that would prevent active participation in performing strengthening exercises at home or increasing physical activity levels


8.Diagnosis of fibromyalgia or a systematic arthritic condition


9.Current or planned pregnancy


10.Recent fall history deemed to impose risk for potential injury

What is involved?

 

 

  1. Online screening

To begin with, you will need to fill in an online screening questionnaire and speak to someone from our research team over the telephone to find out if you are eligible. This should take about 10 minutes in total.

2. Baseline online questionnaires

If you are eligible to participate in the study you will then be invited to answer another online questionnaire, read a participant information sheet, and sign a consent form. This should take about 20 minutes.

3. Intervention

After completing the baseline questionnaire you will be placed into one of two groups (1) the eHealth supported group or (2) the usual care group during 3 months.

This means that you have a 50% chance of being placed in either group.

The eHealth group:

It includes an individually tailored home exercise program and activity plan using a maximum of 6 remote physiotherapy video consultations with a certified health coach and a web application.

The Usual care group:

You will continue to access local care where you would normally go and/or be provided with assistance over the telephone and a referral form to help you access a healthcare professional (e.g. public hospitals). The healthcare professional you decide to visit will provide you with the care for your back pain and/or knee pain.

4. Logbook (weekly paper-based survey)

We will ask you to fill in a paper logbook over the course of 3 months. We will ask you to take a photo of this logbook and to send it back to the research team at the end of the 3 months. The logbook will ask about the treatment you receive, your symptoms, and travel use.

5. 3-month Follow-up online questionnaire

We will also ask you to complete an online questionnaire at 3 months after you are allocated to a group. This should take about 20-30 minutes.

6. 6-month Follow-up Telephone Interview

You will also be contacted by phone to provide feedback on your experience within 6 months of finishing the study. This phone interview will be recorded and take approximately 10 minutes.

Will my details be kept confidential?

No findings that could identify you will be published. All data and results will be handled in a strictly confidential manner. This project is subject to the requirements of the Human Research Ethics Committee of the Royal Prince Alfred Hospital.

What to do next?

If you would like to participate in this study, please click START THE AWARENESS at the bottom of the page to register your interest and answer the screening questions. We will contact you as soon as we can.

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