Internet- and mobile-based treatment of comorbid depression in chronic back pain patients on sick leave

Abstract

Introduction: The high frequency (21-50%) of comorbid depression in chronic back pain patients (CBP) can lead to reduced life quality and increased health care costs. In routine care there is a lack of specialized treatment options for comorbid depression in CBP. In order to reach patients that might need treatment, the usage of health care insurance data might be helpful. Objectives: This study will investigate the usability and effectiveness of an internet and mobile-based intervention for depressed CBP patients in a pilot study with recruitment through a German health insurance company. Methods: For the usability study Think Aloud-Protocols for every treatment module (Introduction, 1-7 and 2 optional modules) were used to examine the intervention in design, user friendliness, user satisfaction, understandability as well as service quality. In a first alpha test, 25 participants tested the general usability. Following the usability study, a RCT will be conducted, comparing the intervention to treatment-as-usual. Adults with CBP, depressive symptoms and currently on sick leave will be included. Primary outcome will be depressive symptom severity; secondary outcomes include biomarkers, self-reported changes in absenteeism, anxiety and life quality. Assessments take place at baseline, 9 weeks, 6 and 12 months after randomization. Participants will be identified using diagnostic data of a large health insurance company. Results: Preliminary results suggest an overall good usability for the intervention. Further results will be presented (research in progress). Discussion: Specific recommendations and improvements were extracted and implemented in the intervention to enhance usability and adherence for the upcoming effectiveness evaluation.