The potential of a multimodal digital care program in addressing healthcare inequities in musculoskeletal pain management

Areias, Anabela C.; Molinos, Maria; Moulder, Robert G.; Janela, Dora; Scheer, Justin K.; Bento, Virgílio; Yanamadala, Vijay; Cohen, Steven P.; Dias Correia, Fernando; Costa, Fabíola

Publication

The potential of a multimodal digital care program in addressing healthcare inequities in musculoskeletal pain management

2023-10Journal article

dc.contributor.author	Areias, Anabela C.
dc.contributor.author	Molinos, Maria
dc.contributor.author	Moulder, Robert G.
dc.contributor.author	Janela, Dora
dc.contributor.author	Scheer, Justin K.
dc.contributor.author	Bento, Virgílio
dc.contributor.author	Yanamadala, Vijay
dc.contributor.author	Cohen, Steven P.
dc.contributor.author	Dias Correia, Fernando
dc.contributor.author	Costa, Fabíola
dc.date.accessioned	2024-07-04T11:41:23Z
dc.date.available	2024-07-04T11:41:23Z
dc.date.issued	2023-10
dc.description.abstract	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.	pt_PT
dc.description.version	info:eu-repo/semantics/publishedVersion	pt_PT
dc.identifier.citation	Areias AC, Molinos M, Moulder RG, et al. The potential of a multimodal digital care program in addressing healthcare inequities in musculoskeletal pain management. NPJ Digit Med. 2023;6(1):188. doi:10.1038/s41746-023-00936-2	pt_PT
dc.identifier.doi	10.1038/s41746-023-00936-2	pt_PT
dc.identifier.issn	2398-6352
dc.identifier.uri	http://hdl.handle.net/10400.16/2999
dc.language.iso	eng	pt_PT
dc.peerreviewed	yes	pt_PT
dc.publisher	Nature Publishing Group	pt_PT
dc.relation.publisherversion	https://doi.org/10.1038/s41746-023-00936-2	pt_PT
dc.rights.uri	http://creativecommons.org/licenses/by/4.0/	pt_PT
dc.title	The potential of a multimodal digital care program in addressing healthcare inequities in musculoskeletal pain management	pt_PT
dc.type	journal article
dspace.entity.type	Publication
oaire.citation.conferencePlace	England	pt_PT
oaire.citation.issue	1	pt_PT
oaire.citation.startPage	188	pt_PT
oaire.citation.title	npj Digital Medicine	pt_PT
oaire.citation.volume	6	pt_PT
person.familyName	Dias Correia
person.givenName	Fernando
person.identifier.orcid	0000-0001-8028-926X
rcaap.rights	openAccess	pt_PT
rcaap.type	article	pt_PT
relation.isAuthorOfPublication	019a51ef-fb6c-4f1e-9c70-59f02bde8139
relation.isAuthorOfPublication.latestForDiscovery	019a51ef-fb6c-4f1e-9c70-59f02bde8139