Evaluating the Feasibility, Acceptability, and Preliminary Clinical Efficacy of a Digital Self-Management Intervention in the Emergency Department: A Pilot Study.

INTRODUCTION

Emergency nurses often struggle to deliver effective discharge education owing to limited tools that support patient self-management behaviors. These behaviors, particularly confidence in managing pain (self-efficacy), are essential for managing acute low back pain and reducing pain severity and interference. This pilot study aimed to develop and evaluate a digital self-management intervention, guided by the individual and family self-management theory, to improve patient-centered outcomes.

METHODS

Conducted over 7 months in 3 emergency departments, adult patients were randomized into 2 groups: (1) standard discharge care or (2) standard care plus the intervention (an educational video and virtual booster sessions at week 2 and week 8). Feasibility and acceptability were assessed using established criteria for pilot studies. Preliminary clinical efficacy (defined as early evidence of clinically meaningful benefits for patients) was evaluated using measures of patient activation, self-efficacy, and pain severity and interference, collected at 1, 6, and 12 weeks after discharge.

RESULTS

Feasibility and acceptability benchmarks were met, with 86% recruitment (n = 30), 80% retention, adherence, study satisfaction, 87% video satisfaction, and 100% engagement and study recommendation. Participants most frequently recalled the actor's demonstrations, which were reinforced during boosters. The intervention group showed consistent improvements across all measures, with minimal clinically important differences in self-efficacy and pain interference at every time point.

DISCUSSION: This study demonstrates that the digital intervention is both feasible and acceptable, with promising early evidence of meaningful clinical benefit. These findings support the need for a larger trial to fully evaluate its impact on patient outcomes.