Effectiveness of the eVISualisation of physical activity and pain intervention (eVIS) in Swedish Interdisciplinary Pain Rehabilitation Programmes: study protocol for a registry-based randomised controlled clinical trial

Veronica Sjöberg, Elena Tseli, Andreas Monnier, Jens Westergren, Riccardo LoMartire, Björn O Äng, Maria Hagströmer, Mathilda Björk, Linda Vixner, Veronica Sjöberg, Elena Tseli, Andreas Monnier, Jens Westergren, Riccardo LoMartire, Björn O Äng, Maria Hagströmer, Mathilda Björk, Linda Vixner

Abstract

Introduction: Living with chronic pain often involves negative consequences. Interdisciplinary Pain Rehabilitation Programmes (IPRP) is considered superior to single-treatment measures in patients with chronic pain. Despite this, effects emerge suboptimal and more than 20% of patients deteriorate in patient-reported physical health outcomes after IPRP. A novel e-Health intervention, eVISualisation (eVIS) of physical activity and pain, was systematically developed to facilitate individualisation of physical activity levels. By adding elements of data collection, visualisation and communication of objectively measured physical activity and patient-reported outcomes (pain intensity, interference of pain, pharmaceutical consumption) to existing treatment modalities in IPRP, the IPRP team acquires prerequisites to adapt advice and physical activity prescriptions and to evaluate set activity goals. The overall aim is twofold. First, the aim is to evaluate the feasibility of the subsequent registry-based randomised controlled clinical trial (R-RCT). Second, the aim is to prospectively evaluate the effectiveness of the eVIS-intervention as a supplement to IPRP on our defined primary (physical health) and secondary outcomes.

Methods and analysis: In the R-RCT, recruitment of 400 patients with chronic pain will be performed at 15 IPRP units. A random allocation to either IPRP + eVIS or to control group that will receive IPRP only will be performed. Data from the initial 30 participants completing the study period (6 months) will be included in a pilot study, where key feasibility outcomes (recruitment, randomisation, implementation, treatment integrity, data collection procedure, preliminary outcome measures) will be evaluated. Outcome variables will be extracted from the web application Pain And TRaining ON-line (PATRON) and from six national registries. Multivariate statistics and repeated measure analyses will be performed. Quality-adjusted life years and incremental cost-effectiveness ratio will be calculated for cost-effectiveness evaluation.

Ethics/dissemination: The Swedish Ethics Review Board granted approval (Dnr 2021/02109). Results will be disseminated through peer-reviewed journals.

Trial registration number: NCT05009459. Protocol V.1.

Keywords: pain management; protocols & guidelines; telemedicine.

Conflict of interest statement

Competing interests: None declared.

© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Figures

Figure 1
Figure 1
CONSORT 2010 flow diagram chart of study design and enrolment. CONSORT, Consolidated Standards of Reporting Trials.
Figure 2
Figure 2
Schematic illustration of the eVIS-intervention’s three elements: (i) the data collection element of physical activity level (steps/day), patient reports of interference of pain on daily activities, pain intensity and pharmacological consumption, (ii) the visualisation element of collected data in different graphs and compilations of data and (iii) the communication element. eVIS, eVISualisation.

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