(871): Web-based treatment follow-up for multidisciplinary pain management programs: Patient usage and short-term treatment outcome of the Arthritis Institute Internet Clinic

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Multidisciplinary chronic pain treatment programs teach patients to incorporate symptom-management strategies into their daily routine, including exercise, activity pacing, relaxation and cognitive-behavioural strategies for stress and emotional distress. Such programs demonstrate decreases in pain, disability levels, health care utilization, and improved psychosocial functioning. However, many patients are unable to maintain these lifestyle changes long-term. This study will determine if web-based treatment follow-up services improve patients’ short-term maintenance of disease management strategies, symptom severity and functional limitations. The Arthritis Institute Internet Clinic (AIIC) provides cost-effective follow-up treatment through interactive, on-line problem-solving / relapse prevention workshops, FAQ pages, and discussion boards. Patients (N= 245) with inflammatory arthritis, osteoarthritis and fibromyalgia were randomly assigned to: 1) treatment (post-treatment access to AIIC) (N= 118) or 2) a standard care control group (N= 127). Usage data revealed that 33.1% of patients accessed the AIIC. Usage varied by diagnosis; a greater percentage of fibromyalgia patients (45.6%) logged on than arthritis patients (21.3%), but arthritis patients had more “hits” per patient (X= 5.54, s.d. = 7.69 vs. X= 2.27, s.d. = 1.25; p< .039). Users rated the AIIC as “helpful”, and 70.4% of users indicated that they found the information / assistance needed. A mixed model (treatment vs. control) MANOVA evaluated the impact of AIIC access on outcome variables (pain severity, fatigue, functional limitations, mood, coping strategy use, health care utilization) at admission, discharge, and one month post-treatment. Treatment and control group outcome measures were equivalent at admit, discharge and one month follow-up, suggesting that access to the AIIC did not provide short-term benefit. Additional analyses investigate variables predicting AIIC use, and compare the treatment outcome of AIIC ‘users” vs. “non-users” and controls. To conclude, this project provides detailed information regarding the appeal, utility and short-term efficacy of web-based treatment follow-up services. Multidisciplinary chronic pain treatment programs teach patients to incorporate symptom-management strategies into their daily routine, including exercise, activity pacing, relaxation and cognitive-behavioural strategies for stress and emotional distress. Such programs demonstrate decreases in pain, disability levels, health care utilization, and improved psychosocial functioning. However, many patients are unable to maintain these lifestyle changes long-term. This study will determine if web-based treatment follow-up services improve patients’ short-term maintenance of disease management strategies, symptom severity and functional limitations. The Arthritis Institute Internet Clinic (AIIC) provides cost-effective follow-up treatment through interactive, on-line problem-solving / relapse prevention workshops, FAQ pages, and discussion boards. Patients (N= 245) with inflammatory arthritis, osteoarthritis and fibromyalgia were randomly assigned to: 1) treatment (post-treatment access to AIIC) (N= 118) or 2) a standard care control group (N= 127). Usage data revealed that 33.1% of patients accessed the AIIC. Usage varied by diagnosis; a greater percentage of fibromyalgia patients (45.6%) logged on than arthritis patients (21.3%), but arthritis patients had more “hits” per patient (X= 5.54, s.d. = 7.69 vs. X= 2.27, s.d. = 1.25; p< .039). Users rated the AIIC as “helpful”, and 70.4% of users indicated that they found the information / assistance needed. A mixed model (treatment vs. control) MANOVA evaluated the impact of AIIC access on outcome variables (pain severity, fatigue, functional limitations, mood, coping strategy use, health care utilization) at admission, discharge, and one month post-treatment. Treatment and control group outcome measures were equivalent at admit, discharge and one month follow-up, suggesting that access to the AIIC did not provide short-term benefit. Additional analyses investigate variables predicting AIIC use, and compare the treatment outcome of AIIC ‘users” vs. “non-users” and controls. To conclude, this project provides detailed information regarding the appeal, utility and short-term efficacy of web-based treatment follow-up services.