West of England highest recruiting region to back pain study

Low back pain (LBP) is one of the most common and costly problems seen in GP surgeries. A poll of 2,000 UK adults revealed that 36% experienced increased LBP during the first COVID-19 lockdown due to a decrease in physical activity and poor workstation set-up at home. SupportBack2 is a randomised controlled trial looking at supporting patients to self-manage LBP with an internet intervention.

Internet interventions may provide a new and efficient way of supporting patients to become more active and help them to self-manage LBP. This trial looked to determine whether the internet intervention called ‘SupportBack’, provided with or without guidance from a physiotherapist over the telephone, was effective in reducing LBP-related disability compared to usual primary care alone.

The West of England was the highest recruiting region in the UK to the study. We spoke to Dr Susanna Cary from Pioneer Medical Group, the highest recruiting site within the West of England, to find out more.

“Back pain is very common and unfortunately, in Bristol there is up to a 40 week wait for access to NHS physiotherapy. For the participants who were randomised, this study was an opportunity to have rapid access to an online self help platform, and/or one-to-one over the phone physiotherapy appointments.

“Sometimes it can be quite difficult to sell studies to our patients, but, as we could offer patients rapid access to physiotherapy, it was easy to get patients and colleagues involved in this study from the offset.”

SupportBack provides advice, reassurance and encourages physical activity over a six week period. The tailored online materials support gradual goal setting, facilitate monitoring of back-related activities and provide personalised feedback.

Dr Cary expanded on why recruitment to this trial was so successful.

“The barrier for GPs is that our time is very limited. There are studies that we want to recruit to but they take up too much of our time.

“One thing that helped us greatly with recruitment to SupportBack 2, was a pop up we built on EMIS (Egton Medical Information Systems). During consultation, when you put the code for LBP or chronic LBP into EMIS, we would get a pop up to say that this person may be eligible for the SupportBack 2 study. This helped a lot, as it’s often the case that you don’t have a lot to offer someone with lower back pain and patients can get quite frustrated.

“I think this trial was a lovely example of how successful research can be in primary care. With a well-designed and relevant study, it was easy to recruit participants within a ten minute consultation.”

SupportBack 2 is now closed to recruitment and in the follow-up stages. If SupportBack proves to be effective, the study team will work towards roll-out into the NHS, allowing GPs and physiotherapists to offer patients SupportBack as a regular part of primary health care.