OBJECTIVE: To investigate the effectiveness and cost-effectiveness of an Internet-based self-management program compared with an online booklet for people with chronic musculoskeletal pain. DESIGN: Parallel-group, randomized controlled superiority trial with economic evaluation conducted in Brazil. METHODS: Patients with chronic musculoskeletal pain were randomly allocated to receive an Internet-based self-management program (ReabilitaDOR) or an online booklet. Participants were recruited from university- and community-based physical therapy clinics and through social media. The primary outcome was pain intensity at 8 weeks. The secondary outcomes were function; quality of life; kinesiophobia; global perceived effect; anxiety and depression; pain catastrophizing; pain-related attitudes and beliefs; self-efficacy; and adverse effects at 8 weeks, 6 months, and 12 months after randomization. The economic evaluation from the societal perspective was conducted for pain intensity and quality-adjusted life years (QALYs). RESULTS: We included 162 participants (ReabilitaDOR, n = 83; online booklet, n = 79). There was no statistically significant difference in pain intensity between groups at 8 weeks (mean difference -0.74; 95% confidence interval -1.5 to 0.04), and no significant differences in the secondary outcomes. From a societal perspective, the intervention had a 0.98 probability of being cost-effective at a willingness-to-pay threshold of $200 per point of improvement in pain intensity and 0.63 at a willingness-to-pay threshold of $50 000 per QALY gained compared to the control group. CONCLUSION: An Internet-based self-management program was not superior to an online booklet for chronic musculoskeletal pain. The Internet-based self-management program seemed to be a cost-effective intervention for pain intensity, but not for QALYs. These findings should be interpreted with caution due to high dropout rates and the trial running during the COVID-19 pandemic.

Full text (sometimes free) may be available at these link(s):      help

• DOI
• PubMed
• publisher