The Effectiveness of a Physician-Led Web Portal on Back Pain: A Cluster Randomized Controlled Trial

Background
It is important for patients with back pain to be well-informed. The well-informed patient is better prepared for self-management and for joint decision-making with the physician. This is why we developed tala-med, a web portal providing up-to-date, evidence-based, independent information on back pain. Primary care physicians can use it in their practices and make it accessible to their patients.
Methods
A cluster randomized controlled trial (registration number DRKS00014279) was carried out in which the primary care physicians (PCPs) in the intervention group (IG: 33 physicians) were directed to use the tala-med web portal in their consultations with patients who had back pain (180 patients). The PCPs in the control group (CG: 12 physicians) were not given access to tala-med and treated their patients with back pain (136 patients) as they had done before. The patients’ informedness about back pain was the primary endpoint: it was assessed by the patients themselves in terms of their subjective degree of knowledge and subjective state of informedness about back pain. Pain intensity, the second endpoint, was assessed with a visual analog scale.
Results
Intention-to-treat analyses revealed that the patients’ subjective degree of knowledge about back pain increased to a greater extent in the intervention group than in the control group (B = 0.25, 95% confidence interval [0.07; 0.43]), as did their subjective state of informedness about back pain (B = 0.51 [0.13; 0.89]). Patients in the intervention group also reported a larger reduction of pain intensity compared to patients in the control group (B = -10.46 [-18.52; -2.38]).
Conclusion
Use of the tala-med web portal by primary care physicians and their patients made patients better informed about back pain and lessened the intensity of their pain. These improvements, although statistically significant, were not large enough to be clinically important.