Interprofessional Management of Chronic Back Pain in Rural and Remote Setting: Use of Telehealth vs. Secure Laptop-based Videoconferencing

Study Overview
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Brief Summary
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This pilot study will evaluate the impact and overall experience of an interprofessional chronic low back pain patient care approach for people in rural and remote areas using Telehealth technology compared to secure laptop based videoconferencing (Vidyo).

Detailed Description
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People with chronic low back pain will be recruited to participate in a team assessment with a local rural nurse practitioner and an-urban based physiotherapist linking through telehealth. The assessment will include a detailed history, physical examination and jointly-delivered education and recommendations for further community-based management. Pre and post measures of self-reported pain, back-specific function, quality of life, and satisfaction will be completed 2-4 weeks after the assessment. Comparison of short-term outcomes will be made with a group of participants from another study using the a different telehealth technology (secure laptop based videoconferencing) same inclusion criteria, measures and health care providers (Clin Trials.gov NCT02225535). The health care providers will be interviewed to get feedback on their preference and experience using the different type of telehealth technology.

Conditions
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Back Pain Lower Back Chronic

Intervention / Treatment
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* Other: interprofessional back pain assessment


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: chronic low back pain localized below costal margins and above gluteal folds and/or related leg pain, which is bad enough to limit their usual activities or daily routine and has been present for at least 3 months Exclusion Criteria: People with: third party payer insurance (i.e.worker's compensation board) for their back related complaints, with primarily neck or thoracic pain, and/ or with language, reading or comprehension barriers that would limit their ability to adequately complete the required study paperwork will be excluded from participating in the study.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Telehealth team assessment<br>Team assessment for back pain with nurse practitioner and physical therapist via telehealth | Other: interprofessional back pain assessment<br>* team assessment and education with urban physical therapist and rural nurse practitioner via telehealth<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Patient experience with telehealth |  | 2-4 weeks after assessment | 
| Pain | Numeric Pain Rating Scale | 2-4 weeks after assessment | 
| Back-specific function | Modified Oswestry Disability Index | 2-4 weeks after assessment | 
| Participant satisfaction | Modified VSQ-9 | 2-4 weeks after assessment | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Health care provider experience | experience with telehealth technology | within 2 weeks of completion of all assessments | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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rural health, telehealth, physiotherapy, interprofessional