Effectiveness of a Guided Internet- and Mobile-Based Intervention for Patients with Chronic Back Pain and Depression (WARD-BP): A Multicenter, Pragmatic Randomized Controlled Trial

Baumeister H, Paganini S, Sander LB, Lin J, Schlicker S, Terhorst Y, Moshagen M, Bengel J, Lehr D, Ebert D (2020)

Publication Type: Journal article

Publication year: 2020

Journal

Psychotherapy and Psychosomatics Karger Publishers

DOI: 10.1159/000511881

Abstract

Introduction: There is neither strong evidence on effective treatments for patients with chronic back pain (CBP) and depressive disorder nor sufficiently available mental health care offers. Objective: The aim is to assess the effectiveness of internet- and mobile-based interventions (IMI) as a scalable approach for treating depression in a routine care setting. Methods: This is an observer-masked, multicenter, pragmatic randomized controlled trial with a randomization ratio of 1:1.Patients with CBP and diagnosed depressive disorder (mild to moderate severity) were recruited from 82 orthopedic rehabilitation clinics across Germany. The intervention group (IG) received a guided depression IMI tailored to CBP next to treatment-as-usual (TAU; including medication), while the control group (CG) received TAU. The primary outcome was observer-masked clinician-rated Hamilton depression severity (9-week follow-up). The secondary outcomes were: further depression outcomes, pain-related outcomes, health-related quality of life, and work capacity. Biostatistician blinded analyses using regression models were conducted by intention-to-treat and per protocol analysis. Results: Between October 2015 and July 2017, we randomly assigned 210 participants (IG, n = 105; CG, n = 105), mostly with only a mild pain intensity but substantial pain disability. No statistically significant difference in depression severity between IG and CG was observed at the 9-week follow-up (beta = -0.19, 95% CI -0.43 to 0.05). Explorative secondary depression (4/9) and pain-related (4/6) outcomes were in part significant (p < 0.05). Health-related quality of life was significantly higher in the IG. No differences were found in work capacity. Conclusion: The results indicate that an IMI for patients with CBP and depression in a routine care setting has limited impact on depression. Benefits in pain and health-related outcomes suggest that an IMI might still be a useful measure to improve routine care.

Authors with CRIS profile

Sandra Schlicker Lehrstuhl für Klinische Psychologie und Psychotherapie David Ebert Lehrstuhl für Klinische Psychologie und Psychotherapie

Involved external institutions

Universität Ulm DE Germany (DE) Albert-Ludwigs-Universität Freiburg DE Germany (DE) Leuphana Universität Lüneburg DE Germany (DE)

How to cite

APA:

Baumeister, H., Paganini, S., Sander, L.B., Lin, J., Schlicker, S., Terhorst, Y.,... Ebert, D. (2020). Effectiveness of a Guided Internet- and Mobile-Based Intervention for Patients with Chronic Back Pain and Depression (WARD-BP): A Multicenter, Pragmatic Randomized Controlled Trial. Psychotherapy and Psychosomatics. https://dx.doi.org/10.1159/000511881

MLA:

Baumeister, Harald, et al. "Effectiveness of a Guided Internet- and Mobile-Based Intervention for Patients with Chronic Back Pain and Depression (WARD-BP): A Multicenter, Pragmatic Randomized Controlled Trial." Psychotherapy and Psychosomatics (2020).

BibTeX: Download