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    Has all of the relevant evidence been taken into account?

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    Are the summaries of clinical and cost effectiveness reasonable interpretations of the evidence?

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    Are the recommendations sound and a suitable basis for guidance to the NHS?

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    Are there any equality issues that need special consideration and are not covered in the medical technology consultation document?
The content on this page is not current guidance and is only for the purposes of the consultation process.

EARLY VALUE ASSESSMENT PROGRAMME

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2 The technologies

2.1 Digital technologies for managing low back pain (LBP) could provide rapid access to specialist advice and guidance, remote pain management support including physical activity recommendations and psychological therapies through web-based applications and digital platforms. They could offer greater flexibility because people can work through the recommendations in their own time with varying levels of support. Digital technologies for managing LBP are not homogenous and have different focuses based on the characteristics of the person with LBP. For example, some technologies are designed for acute LBP, some for chronic LBP and some for a mixture of both.

2.2 NICE has assessed 9 digital technologies for managing non-specific LBP. The assessment included technologies that offer physical, psychological, or both types of management of LBP. The criteria for including technologies in this assessment are in the final scope on the NICE website. The included technologies are:

  • ACT for PAIN (Pain Medicine Specialist Ltd)

  • Ascenti Reach (Ascenti)

  • getUBetter (getUBetter)

  • Hinge Health (Hinge Health)

  • Kaia (Kaia Health)

  • Pathway through Pain (Wellmind Health)

  • Phio Engage (EQL)

  • selfBACK (SelfBack Consortium)

  • SupportBack (University of Southampton).

See table 2.1 in the assessment report for details of the technologies.

Care pathway

2.3 The target population for this assessment is people aged 16 and over with non-specific LBP. The condition can either be acute (that is, lasting less than 3 months) or chronic (that is, lasting 3 months or more). NICE's guideline on low back pain and sciatica in over 16s recommends considering several non-pharmacological interventions for treating LBP. These include self-management, exercise, manual therapies, psychological therapies, combined physical and psychological programmes, and return to work programmes. It recommends that these interventions are tailored to someone's specific needs, preferences and capabilities.

2.4 Acceptance and commitment therapy (ACT) and cognitive behavioural therapy (CBT) delivered by healthcare professionals with appropriate training are recommended in NICE's guideline on chronic pain (primary and secondary) in over 16s.

2.5 Digital technologies for managing LBP would be offered after clinical assessment and diagnosis, or through self-referral, as an addition to non-pharmacological treatment for LBP. Technologies eligible for self-referral will be those with integrated assessment and risk stratification. This is to ensure that red flags which may indicate a serious underlying cause are identified. Technologies that provide psychological support only may not be suitable for people with acute LBP because their pain has lasted less than 3 months.

The comparator

2.6 The comparator is standard care for managing non-specific LBP. Digital technologies would be used in addition to standard care. Standard care varies significantly across primary and community care.