The potential of a multimodal digital care program in addressing healthcare inequities in musculoskeletal pain management.
Journal
NPJ digital medicine
ISSN: 2398-6352
Titre abrégé: NPJ Digit Med
Pays: England
ID NLM: 101731738
Informations de publication
Date de publication:
10 Oct 2023
10 Oct 2023
Historique:
received:
06
03
2023
accepted:
29
09
2023
medline:
11
10
2023
pubmed:
11
10
2023
entrez:
10
10
2023
Statut:
epublish
Résumé
Digital interventions have emerged as a solution for time and geographical barriers, however, their potential to target other social determinants of health is largely unexplored. In this post-hoc analysis, we report the impact of social deprivation on engagement and clinical outcomes after a completely remote multimodal musculoskeletal (MSK) digital care program managed by a culturally-sensitive clinical team. Patients were stratified in five categories according to their social deprivation index, and cross-referenced with their race/ethnicity, rurality and distance to healthcare facilities. From a total of 12,062 patients from all U.S. states, 8569 completed the program. Higher social deprivation was associated with greater baseline disease burden. We observed that all categories reported pain improvements (ranging from -2.0 95%CI -2.1, -1.9 to -2.1 95%CI -2.3, -1.9, p < 0.001) without intergroup differences in mean changes or responder rates (from 59.9% (420/701) to 66.6% (780/1172), p = 0.067), alongside reduction in analgesic consumption. We observed significant improvements in mental health and productivity across all categories, with productivity and non-work-related functional recovery being greater within the most deprived group. Engagement was high but varied slightly across categories. Together these findings highlight the importance of a patient-centered digital care program as a tool to address health inequities in musculoskeletal pain management. The idea of investigating social deprivation within a digital program provides a foundation for future work in this field to identify areas of improvement.
Identifiants
pubmed: 37816899
doi: 10.1038/s41746-023-00936-2
pii: 10.1038/s41746-023-00936-2
pmc: PMC10564877
doi:
Types de publication
Journal Article
Langues
eng
Pagination
188Informations de copyright
© 2023. Springer Nature Limited.
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