Session Information
Session Title: AA 2022 Posters - Musculoskeletal and Sports Medicine
Session Time: None. Available on demand.
Disclosures: Ashwin J. Leo, BA: No financial relationships or conflicts of interest
Background and/or Objectives: Although depression and anxiety negatively impact patients’ responses to standard musculoskeletal treatment, mental health is not routinely addressed in musculoskeletal care. This study compared changes in mental and physical health between musculoskeletal patients who received a digital mental health intervention in addition to usual musculoskeletal care, patients who received usual care only, and patients who received in-person counseling plus usual care.
Design: Retrospective cohort study.
Setting: Musculoskeletal physiatry clinic of a tertiary academic institution.
Participants: Adult patients presenting for musculoskeletal pain with coexisting symptoms of depression and/or anxiety (Patient-Reported Outcomes Measurement Information System (PROMIS) Depression and/or Anxiety score ≥ 55).
Interventions: All patients received usual musculoskeletal care. The added intervention was an application that used chatbot technology and human counselors to provide cognitive behavioral therapy, mindfulness training, and sleep tools. The “gold standard” comparison intervention was 2+ in-person sessions with a licensed clinical psychologist.
Main Outcome Measures: Between-cohort differences in the 2-month longitudinal changes in PROMIS Depression and Anxiety (primary outcomes) and Pain Interference and Physical Function (secondary outcomes), after adjusting for age and body mass index.
Results: Among 153 patients (mean age 55 (SD 15) years, 128 (84%) female, 51 patients per cohort), patients who received the digital intervention made meaningfully greater improvements in PROMIS Depression, Pain Interference, and Physical Function than patients who received usual care alone (mean between-group difference -4.8, -2.6, and 2.7 points respectively, p≤.04). They also reported meaningfully greater improvement in PROMIS Physical Function (2.4 points, p=.04) and equivalent improvements in PROMIS Depression, Anxiety, and Pain Interference compared to patients who received in-person counseling.
Conclusions: Compared to usual musculoskeletal care alone, incorporation of a digital mental health intervention into usual care may improve physical and mental health outcomes for musculoskeletal patients with coexisting symptoms of depression and/or anxiety, possibly to a comparable degree as improvements from incorporation of in-person counseling into usual care.
Level of Evidence: Level III
To cite this abstract in AMA style:
Leo AJ, Hunt D, Cheng AL. Digital Mental Health Intervention Plus Usual Care Compared to Usual Care Only and Usual Care Plus In-person Psychological Counseling for Musculoskeletal Patients with Depression And/or Anxiety [abstract]. PM R. 2022; 14(S1)(suppl 1). https://pmrjabstracts.org/abstract/digital-mental-health-intervention-plus-usual-care-compared-to-usual-care-only-and-usual-care-plus-in-person-psychological-counseling-for-musculoskeletal-patients-with-depression-and-or-anxiety/. Accessed May 16, 2025.« Back to AAPM&R Annual Assembly 2022
PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/digital-mental-health-intervention-plus-usual-care-compared-to-usual-care-only-and-usual-care-plus-in-person-psychological-counseling-for-musculoskeletal-patients-with-depression-and-or-anxiety/