#usability and Acceptability of an App-Based Approach to Treat Low Back Pain: Preplanned Secondary Analysis of a Randomized Controlled Trial
Background: Low back pain (LBP) is a major cause of disability globally. To tackle issues like long wait times and limited access to conventional care, telemedicine is emerging as a viable alternative. It offers benefits like reduced travel and increased flexibility, with evidence showing comparable effectiveness to in-person care. However, #usability remains a key challenge, impacting patient compliance. Objective: In a three-arm randomised controlled trial, our pre-planned secondary analysis aimed to assess the #usability and patient perceptions toward an autonomous app-based intervention ("NOLA") for low back pain in order to improve clinical practice of telemedicine interventions. Objectives included evaluating app #usability, assessing perceptions toward telemedicine, and exploring app usage, adherence, and motivation. Methods: Low back pain patients were recruited from May to August 2022 and randomised into App, Physio+App, or Physio groups. App and Physio+App groups were included in this sub-analysis. Intervention duration was 6 weeks. Data on baseline characteristics, System #usability Scale, Telemedicine Perception Questionnaire, app usage, adherence, and motivation were collected online. Results: 64 participants were randomized to use the app with available data for 38. The mean age of participants who completed was 49.9 (SD 13.6) years, with 78% experiencing low back pain for more than two years. #usability scores (0-100) were good (Median (IQR) Physio+App: 78 (58-92), App: 86 (65-91)). Positive telemedicine perceptions were noted with 84% rating it an adequate addition to usual care. App usage varied, with 43% using it three to five days per week, and 64% reported motivation to use the app. The drop-out rates (App: 14/32, 44%; Physio+App: 12/32, 38%; Physio: 11/29, 38%) were similar, but participants who dropped out had statistically significant less pain (completers: mean 3.9 (SD 2.0); drop-outs: mean 3.0 (SD 2.0); P=.02). Reasons for drop-out were mostly not related to the app. Conclusions: The app "NOLA" demonstrated good #usability, and participants expressed positive perceptions toward telemedicine. Despite concerns about the lack of physical contact, the majority considered telemedicine a convenient form of healthcare delivery. App usage and motivation were favourable, emphasizing the potential of app-based interventions in managing low back pain. Clinical Trial: German Clinical Trial Registry (DRKS00029099)
