Older Adult Use and Outcomes in a Digital Musculoskeletal (MSK) Program, by Generation.

Grace Wang,Jeannie F Bailey,Jeffrey Krauss,Manshu Yang

doi:10.3389/fdgth.2021.693170

Abstract

Objective: We investigated use and clinical outcomes in a digital musculoskeletal (MSK) program, by generation.Method: This longitudinal study uses retrospective data collected online or by app. The study included adults with 12 or more weeks of pain who took part in a digital MSK program. We compared Gen Z and Millennials, Gen X, working age Baby Boomers, and retiree age Baby Boomer and Silent Generation. Program use outcomes were program start, program completion, and number of exercises, educational articles, and messages to coaches. Clinical outcomes were changes in pain, depression, and anxiety from baseline to 12 weeks. We calculated descriptive statistics and conducted adjusted regression models.Results: Odds of starting the program were significantly higher for Gen Xers (OR: 1.12) and working age Baby Boomers (OR: 1.37) vs. Gen Zers and Millennials. Compared to Gen Zers and Millennials, we observed significantly higher odds of program completion among Gen Xers (OR: 1.62), working age Baby Boomers (OR: 2.24), and retirees (OR: 2.36). Compared to Gen Zers and Millennials, retirees had 19 more exercise sessions (IRR: 1.69), accessed 11 more articles (IRR: 1.84), and sent 4 more messages to coaches (IRR: 1.26). Compared to Gen Z and Millennials, we observed no significant differences in change in pain for Gen Xers, working age Baby Boomers, or retirees.Conclusions: Adults from multiple generations took part in a digital MSK program. Findings suggest that older generations used a digital MSK program more than younger generations, but had similar pain outcomes.

Highlights

Chronic musculoskeletal (MSK) pain is a leading cause of disability and cost in the United States, especially among older adults
We reviewed the baseline questionnaires to ensure that participants met the following program criteria: age 18 or older; pain in the low back, knee, shoulder, hip, or neck; baseline visual analog scale (VAS) pain score >0; pain lasted for at least 12 weeks; and member covered by employer’s health plan
For our primary study objective about digital MSK program use, we focused on five service use outcomes: program start; program completion; total exercise sessions by program week 12; total education articles read by program week 12; and total number of member-initiated messages to coaches by program week 12

Summary

Introduction

Chronic musculoskeletal (MSK) pain is a leading cause of disability and cost in the United States, especially among older adults. Prevalence and incidence rates in the United States of osteoarthritis, back and neck pain, and other MSK disorders are among the highest in the world [1]. In 2018, 134.5 million adults in the United States reported MSK conditions with older adults experiencing higher prevalence rates of MSK conditions and limitations compared to younger adults [2, 3]. Chronic MSK pain often occurs together with depression and anxiety [4]. Depression and anxiety can increase pain severity, the experience of pain, and the pain duration [5,6,7,8]

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Results

Conclusion