PMID- 30500464 OWN - NLM STAT- MEDLINE DCOM- 20200227 LR - 20200227 IS - 1878-1632 (Electronic) IS - 1529-9430 (Linking) VI - 19 IP - 5 DP - 2019 May TI - A web-based platform to accommodate symptoms of anxiety and depression by featuring social interaction and animated information in patients undergoing lumbar spine fusion: a randomized clinical trial. PG - 827-839 LID - S1529-9430(18)31250-6 [pii] LID - 10.1016/j.spinee.2018.11.011 [doi] AB - BACKGROUND: Approximately one-third of patients undergoing spine surgery have symptoms of anxiety and depression that correlate with pain, disability, and lower health-related quality of life. The use of web-based informative strategies before surgery and principles from cognitive behavioral therapy, have been applied in other patient groups, facilitating mobility and encouraging beneficial coping behavior. PURPOSE: To examine the effect of a web-based Spine Platform featuring Interaction and Information by Animation (w-SPIINA) on symptoms of anxiety and depression, pain, disability, and health-related quality of life. STUDY DESIGN: A single-center, two-arm, randomized controlled trial PATIENT SAMPLE: One hundred fourteen consecutive patients scheduled for instrumented lumbar spine fusion due to degenerative disc disease or spondylolisthesis. OUTCOME MEASURES: Primary outcome was the change in self-reported Hospital Anxiety and Depression Scale (HADS) scores from baseline to 3-month follow-up. Secondary outcomes were change in HADS 1-day before surgery 2days and 6 months after and changes in self-reported disability measured on the Oswestry disability index (ODI), quality of life (EQ-5D-5L questionnaire), and the low back pain rating scale (LBPRS) 2days and 3 and 6 months after surgery. METHOD: Patients were randomized to either a control group receiving a standard information regimen or an intervention group gaining access to w-SPIINA in addition to the standard regimen. The independent charity Helsefonden contributed $45,000, the Health Research Fund of the Regional Hospital Central Jutland contributed $10,000, and the Toyota foundation contributed $10,000 to remunerate a dedicated investigator. The authors have no conflict of interest to declare. RESULTS: There was no statistically significant difference within the w-SPIINA group and the control group regarding changes in HADS at 3-month follow-up (p>/=.37). Approximately 40% reached minimum clinically important difference (MCID) in the w-SPIINA group on the HADS at 3 months. In the control group 50% reached MCID on anxiety subscale and 35% on the depression subscale at 3 months. No statistically significant differences were found between groups with regard to the overall outcomes at any of the predefined time points. CONCLUSION: Providing patients with access to w-SPIINA in addition to a standard information regimen had no additional effect on HADS and patient-reported outcomes1day before, 2days, 3 or 6 months after surgery. However, a high compliance and degree of interaction with w-SPIINA indicates that this mode of web-based support could be applicable in this group of patients. CI - Copyright (c) 2018 The Authors. Published by Elsevier Inc. All rights reserved. FAU - Strom, Janni AU - Strom J AD - Centre of Elective Surgery, Regional Hospital of Silkeborg, Silkeborg, Denmark; Department of Public Health, Section for Clinical Social Medicine and Rehabilitation, Aarhus University, Aarhus, Denmark. Electronic address: jannistrom@yahoo.dk. FAU - Nielsen, Claus Vinther AU - Nielsen CV AD - Department of Public Health, Section for Clinical Social Medicine and Rehabilitation, Aarhus University, Aarhus, Denmark; DEFACTUM, Central Denmark Region, Denmark. FAU - Jorgensen, Lene Bastrup AU - Jorgensen LB AD - Centre of Elective Surgery, Regional Hospital of Silkeborg, Silkeborg, Denmark; Department of Clinical Medicine, Section for Public Health, Aarhus University, Aarhus, Denmark. FAU - Andersen, Niels Trolle AU - Andersen NT AD - Department of Biostatistics, Section for Public Health, Aarhus University, Aarhus, Denmark. FAU - Laursen, Malene AU - Laursen M AD - Centre of Elective Surgery, Regional Hospital of Silkeborg, Silkeborg, Denmark. LA - eng PT - Journal Article PT - Randomized Controlled Trial DEP - 20181127 PL - United States TA - Spine J JT - The spine journal : official journal of the North American Spine Society JID - 101130732 SB - IM MH - Adult MH - Aged MH - Anxiety/etiology/*prevention & control MH - Depression/etiology/*prevention & control MH - Female MH - Humans MH - Internet MH - *Interpersonal Relations MH - Intervertebral Disc Degeneration/complications/psychology/surgery MH - Lumbar Vertebrae/surgery MH - Male MH - Middle Aged MH - Patient Education as Topic/*methods MH - Postoperative Complications/*epidemiology/psychology MH - Spinal Fusion/*adverse effects/psychology MH - Spondylolisthesis/complications/psychology/surgery OTO - NOTNLM OT - Animation OT - Anxiety OT - Depression OT - Information OT - Lumbar spine fusion OT - Randomized trial OT - Web-based platform EDAT- 2018/12/01 06:00 MHDA- 2020/02/28 06:00 CRDT- 2018/12/01 06:00 PHST- 2018/07/05 00:00 [received] PHST- 2018/11/26 00:00 [revised] PHST- 2018/11/26 00:00 [accepted] PHST- 2018/12/01 06:00 [pubmed] PHST- 2020/02/28 06:00 [medline] PHST- 2018/12/01 06:00 [entrez] AID - S1529-9430(18)31250-6 [pii] AID - 10.1016/j.spinee.2018.11.011 [doi] PST - ppublish SO - Spine J. 2019 May;19(5):827-839. doi: 10.1016/j.spinee.2018.11.011. Epub 2018 Nov 27.