Determinants of Adherence to the Online Component of a Blended Intervention for Patients with Hip and/or Knee Osteoarthritis: A Mixed Methods Study Embedded in the e-Exercise Trial

Vries, Herman de; Kloek, Corelien; Bakker, D.H. de; Dekker, Joost; Bossen, Daniël; Veenhof, Cindy

doi:10.1089/tmj.2016.0264

Cited by 39 publications

(46 citation statements)

References 38 publications

(47 reference statements)

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“…Others find that socioeconomic status, comprising education and employment status, predicts ISG use [1,19,27,28]. However, corresponding to our findings, lack of such predictors was also found in a recent study published from the UK that included 863 depressed and anxious participants [29].…”

Section: Discussionsupporting

confidence: 88%

Lumbar Spine Fusion Patients’ Use of an Internet Support Group: Mixed Methods Study (Preprint)

Strøm¹,

Høybye²,

Laursen³

et al. 2018

Preprint

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Background: Use of the Internet within a healthcare context offers possibilities, not only to provide information, but also to establish support online. Internet Support Groups (ISGs) are often used by patients with cancer or depression, offering potentials and advantages not provided by face-to-face support. Use of an ISG could be beneficial in patients undergoing lumbar spine fusion (LSF), accommodating isolation after surgery, providing a sense of social life, and contributing to the overall health-related quality of life providing peer support. However, research indicates that LSF patients are often not Internet users, as they often belong to the low-income group, have low education, and are of older age. However, knowledge of LSF patients' use of ISG is limited. Objective: This study describes and analyses the use of an ISG in Danish patients undergoing instrumented LSF due to degenerative spine disorders. Method: A prospective, randomized controlled trial of 114 patients, half of whom were randomized to receive access to an ISG and half to a control group with no access. This study is a prospective cohort where the population comprised those patients randomized to access the ISG (n=57). Sociodemographic characteristics (gender, age, marital status, employment status, and level of education) and information on psychological wellbeing (symptom of anxiety and depression) were obtained at baseline, 1-5 weeks prior to surgery, and the use of the ISG was registered from baseline until 3 months after surgery. Results: Eight participants were excluded. Thus, 49 participants comprised the study population, with a mean age of 53 years (range 29-77), 57% female, 84% not living alone, 70% unemployed, and the majority (69%) had secondary education as their highest education. Approximately one-third of the participants had symptoms of depression (33%), and one-third had symptoms of anxiety (31%), half of these overlapped, having both anxiety and depression. A total of 43 of the 49 participants (88%) took the opportunity to access the ISG. We found no correlations between sociodemographic data and the degree to which participants accessed the ISG. Women were more prone to be active users (P=0.04) and more often contributed with posts to the ISG. Finally, participants who were active users and contributed with posts or comments had more interactions (P<0.001) and pageviews (P<0.001). Conclusions: Sociodemographic characteristics were not predictors of ISG use in this study.

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Section: Discussionsupporting

confidence: 88%

Lumbar Spine Fusion Patients’ Use of an Internet Support Group: Mixed Methods Study (Preprint)

Strøm¹,

Høybye²,

Laursen³

et al. 2018

Preprint

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“…Of these participants, 73 (81.1%) completed at least 8 of 12 modules and were classified as “adherent.” A detailed overview of adherence to e-Exercise and related factors is published elsewhere. 27 …”

Section: Resultsmentioning

confidence: 99%

“…They were considered to be adhering to the intervention if they completed at least 8 of 12 modules. 27 …”

Section: Methodsmentioning

confidence: 99%

Effectiveness of a Blended Physical Therapist Intervention in People With Hip Osteoarthritis, Knee Osteoarthritis, or Both: A Cluster-Randomized Controlled Trial

et al. 2018

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BackgroundIntegrating physical therapy sessions and an online application (e-Exercise) might support people with hip osteoarthritis (OA), knee OA, or both (hip/knee OA) in taking an active role in the management of their chronic condition and may reduce the number of physical therapy sessions.ObjectiveThe objective of this study was to investigate the short- and long-term effectiveness of e-Exercise compared to usual physical therapy in people with hip/knee OA.DesignThe design was a prospective, single-blind, multicenter, superiority, cluster- randomized controlled trial.SettingThe setting included 143 primary care physical therapist practices.ParticipantsThe participants were 208 people who had hip/knee OA and were 40 to 80 years of age.Interventione-Exercise is a 3-month intervention in which about 5 face-to-face physical therapy sessions were integrated with an online application consisting of graded activity, exercise, and information modules. Usual physical therapy was conducted according to the Dutch physical therapy guidelines on hip and knee OA.MeasurementsPrimary outcomes, measured at baseline after 3 and 12 months, were physical functioning and free-living physical activity. Secondary outcome measures were pain, tiredness, quality of life, self-efficacy, and the number of physical therapy sessions.ResultsThe e-Exercise group (n = 109) received, on average, 5 face-to-face sessions; the usual physical therapy group (n = 99) received 12. No significant differences in primary outcomes between the e-Exercise group and the usual physical therapy group were found. Within-group analyses for both groups showed a significant improvement in physical functioning. After 3 months, participants in the e-Exercise group reported an increase in physical activity; however, no objectively measured differences in physical activity were found. With respect to secondary outcomes, after 12 months, sedentary behavior significantly increased in the e-Exercise group compared with the usual physical therapy group. In both groups, there were significant improvements for pain, tiredness, quality of life, and self-efficacy.LimitationsThe response rate at 12 months was 65%.ConclusionsThe blended intervention, e-Exercise, was not more effective than usual physical therapy in people with hip/knee OA.

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“…Patients treated with e-Exercise Osteoarthritis experienced improvements in physical functioning, pain, tiredness, quality of life and selfefficacy [23]. Moreover, patients were highly positive and satisfied with the availability of information and assignments regardless of time or place [24]. The treatment of non-specific LBP is similar in nature to osteoarthritis of the hip and/or knee, as core treatment elements include physical activity, exercise and information.…”

Section: Introductionmentioning

confidence: 99%

Development and proof of concept of a blended physiotherapeutic intervention for patients with non-specific low back pain

et al. 2019

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Objective To develop a blended physiotherapeutic intervention for patients with non-specific low back pain (e-Exercise LBP) and evaluate its proof of concept. Design Focus groups with patients, physiotherapists, and eHealth and LBP experts were conducted to investigate values according to the development of e-Exercise LBP. Proof of concept was evaluated in a multicentre study. Setting Dutch primary care physiotherapy practices (n = 21 therapists). Participants Adults with non-specific LBP (n = 41). Intervention e-Exercise LBP was developed based on clinical LBP guidelines and the focus groups, using the Center for eHealth Research Roadmap. Face-to-face physiotherapy sessions were integrated with a web application consisting of 12 information lessons, video-supported exercises and a physical activity module with the option to gradually increase individuals' level of physical activity. The intervention could be tailored to patients' risk of persistent disabling LBP, according to the STarT Back Screening Tool. Main outcome measures Functional disability, pain, physical activity, sedentary behaviour and fear-avoidance beliefs, measured at baseline and 12 weeks. Results After 12 weeks, improvements were found in functional disability [Quebec Back Pain Disability Scale: mean difference (MD) −12.2/100; 95% confidence interval (CI) 8.3 to 16.1], pain (Numeric Pain Rating Scale: MD −2.8/10; 95% CI 2.1 to 3.6), subjective physical activity (Short Questionnaire to Assess Health Enhancing Physical Activity: MD 11.5 minutes/day; 95% CI −47.8 to 24.8) and objective sedentary behaviour (ActiGraph: MD −23.0 minutes/day; 95% CI −8.9 to 55.0). Small improvements were found in objective physical activity and fear-avoidance beliefs. The option to gradually increase physical activity was activated for six patients (15%). On average, patients received seven face-to-face sessions alongside the web application.Conclusions The results of this study provide the first indication of the effectiveness of e-Exercise LBP, particularly for disability and pain among patients with LBP. Future studies will focus on end-user experiences and (cost-) effectiveness.

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Determinants of Adherence to the Online Component of a Blended Intervention for Patients with Hip and/or Knee Osteoarthritis: A Mixed Methods Study Embedded in the e-Exercise Trial

Abstract: The majority of the participants adhered to the online component of e-Exercise, illustrating its applicability. The integration within the physiotherapy setting and intervention's persuasive design appear to have an important role in optimizing patient adherence.

Cited by 39 publications

References 38 publications

Lumbar Spine Fusion Patients’ Use of an Internet Support Group: Mixed Methods Study (Preprint)

Lumbar Spine Fusion Patients’ Use of an Internet Support Group: Mixed Methods Study (Preprint)

Effectiveness of a Blended Physical Therapist Intervention in People With Hip Osteoarthritis, Knee Osteoarthritis, or Both: A Cluster-Randomized Controlled Trial

Development and proof of concept of a blended physiotherapeutic intervention for patients with non-specific low back pain

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