Can a Back Pain E-mail Discussion Group improve health status and lower health care costs?: A randomized study

Arch Intern Med. 2002 Apr 8;162(7):792-6. doi: 10.1001/archinte.162.7.792.


Background: Given the high health care utilization, limited evidence for the effectiveness of back pain interventions, and the proliferation of e-mail health discussion groups, this study seeks to determine if the Internet can be used to improve health status and health care utilization for people with chronic back pain.

Methods: Randomized controlled trial. Participants included 580 people from 49 states with chronic back pain having at least 1 outpatient visit in the past year, no "red-flag" symptoms, and access to e-mail. Major exclusion criteria included continuous back pain for more than 90 days causing major activity intolerance and/or receiving disability payments.

Intervention: Closed, moderated, e-mail discussion group. Participants also received a book and videotape about back pain. Controls received a subscription to a non-health-related magazine of their choice.

Main outcome measures: Pain, disability, role function, health distress, and health care utilization.

Results: At 1-year treatment, subjects compared with controls demonstrated improvements in pain (P =.045), disability (P =.02), role function (P =.007), and health distress (P =.001). Physician visits for the past 6 months declined by 1.5 visits for the treatment group and by 0.65 visits for the control group (P =.07). Mean hospital days declined nearly 0.20 days for the treated group vs and increased 0.04 days for the control group (P =.24).

Conclusions: An e-mail discussion group can positively affect health status and possibly health care utilization. It may have a place in the treatment of chronic recurrent back pain.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Back Pain / economics
  • Back Pain / therapy*
  • Case-Control Studies
  • Computer Communication Networks*
  • Female
  • Health Education
  • Health Services / statistics & numerical data*
  • Health Status*
  • Humans
  • Male
  • Middle Aged
  • Patient Acceptance of Health Care
  • Self-Help Groups*
  • Surveys and Questionnaires
  • United States